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1

A case report of testicular sparganosis misdiagnosed as testicular tumor.  

PubMed

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent. PMID:25045238

Park, Won Hee; Shin, Tae Young; Yoon, Sang Min; Park, Soo-Hwan; Kang, Yong Jin; Kim, Do Kyung; Han, Jee-Young; Seong, Do Hwan

2014-07-01

2

A Case Report of Testicular Sparganosis Misdiagnosed as Testicular Tumor  

PubMed Central

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent. Graphical Abstract PMID:25045238

2014-01-01

3

Vulva Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Vulva Anatomy View/Download: Small: 720x634 View Download Add to My Pictures Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

4

Angiokeratoma of vulva mimicking genital warts.  

PubMed

Angiokeratoma of vulva is a relatively rare lesion which is occasionally misdiagnosed as melanoma, pyogenic granuloma, seborrheic keratosis, or genital warts. We report a case of vulvar angiokeratomas which were diagnosed and managed as genital warts. All asymptomatic dull red-colored papules over vulva should be subjected to astute clinical and histological examination to diagnose angiokeratoma and differentiate it from other lesions. PMID:25404845

Dhawan, Amit Kumar; Pandhi, Deepika; Goyal, Surbhi; Bisherwal, Kavita

2014-12-01

5

Sparganosis of liver: a rare entity and review of literature.  

PubMed

Humans are known to serve as the secondary intermediate host for some larval forms of canine or feline tapeworms. Sparganosis is caused by plerocercoid larva of Spirometra of which there are three main species; Spirometra mansoni (or Spirometra erinaceieuropaei), Spirometra mansonoides and Spirometra proliferum. A one-and-half-year-old patient presenting with febrile illness was diagnosed radiologically as a case of liver abscess. The aspirate from the abscess cavity had a thin thread-like worm which was identified as a larval stage of Pseudophyllidea that was further confirmed as belonging to genus Spirometra. Aspiration of the worm and antiparasitic therapy with metronidazole led to complete recovery. Reports of sparganosis from Indian subcontinent are scanty and these cases had involvement of brain, kidney and eye. To the best of our knowledge this is the first case of hepatic sparganosis from India. PMID:23220827

Khurana, Sumeeta; Appannanavar, Suma; Bhatti, Harinder Singh; Verma, Sanjay

2012-01-01

6

Fournier's gangrene associated with sparganosis in the scrotum.  

PubMed

Fournier's gangrene is a necrotizing fasciitis of the scrotum or perineum that may extend by way of the fascial planes to the penis and the anterior abdominal wall up to the clavicles, buttocks, or lower extremities. It is a life-threatening progressive disease that requires aggressive antibiotic therapy and early radical debridement. Sparganosis is a parasitic infection that occurs principally in cats and dogs, but human infestations have been reported, albeit rarely. Recently, we experienced a case of Fournier's gangrene associated with sparganosis in the scrotum, which was treated with antibiotics and extensive debridement including removal of a white, flat, shiny sparganum worm. PMID:14751384

Jeong, Hee Jong

2004-01-01

7

Angiomyofibroblastoma of the vulva  

PubMed Central

Angiomyofibroblastoma (AMFB) is an uncommon benign mesenchymal tumor. AMFB occurs almost in the vulvo-vaginal area of women. The gross features of AMFB are well-circumscribed so it clinically is often thought as Bartholin gland cyst or aggressive angiomyxoma. Usually, most tumors grow slowly, and patients do not feel pain. It also has low tendency for local recurrence. The histologic findings of the tumors are abundant thin-walled blood vessels with hypocellular and hypercellular areas. Almost all tumor cells have immunoreactivity for both desmin and vimentin. It also has estrogen and/or progesterone receptors, but staining for cytokeratin is negative. Here is a case of AMFB of the vulva occurring in a 40-year-old woman, involving the right labia majora. The patient described that her vulva mass grew in about few months. The maximum dimension of the tumor was measured as 2 cm, and we resected the tumor one month after as her second visit. PMID:24328028

Seo, Jung-Won; Lee, Kyoung-A; Yoon, Na-Ra; Kim, Byoung-Gie; Bae, Duk-Soo

2013-01-01

8

Angiomyofibroblastoma of the vulva.  

PubMed

Angiomyofibroblastoma (AMFB) is an uncommon benign mesenchymal tumor. AMFB occurs almost in the vulvo-vaginal area of women. The gross features of AMFB are well-circumscribed so it clinically is often thought as Bartholin gland cyst or aggressive angiomyxoma. Usually, most tumors grow slowly, and patients do not feel pain. It also has low tendency for local recurrence. The histologic findings of the tumors are abundant thin-walled blood vessels with hypocellular and hypercellular areas. Almost all tumor cells have immunoreactivity for both desmin and vimentin. It also has estrogen and/or progesterone receptors, but staining for cytokeratin is negative. Here is a case of AMFB of the vulva occurring in a 40-year-old woman, involving the right labia majora. The patient described that her vulva mass grew in about few months. The maximum dimension of the tumor was measured as 2 cm, and we resected the tumor one month after as her second visit. PMID:24328028

Seo, Jung-Won; Lee, Kyoung-A; Yoon, Na-Ra; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

2013-09-01

9

Aggressive angiomyxoma of the vulva: a précis for primary care providers.  

PubMed

Vulvar aggressive angiomyxoma (AA) is a rare mesenchymal tumor of the vulva. Due to its slow-growing nature, it is often overlooked and misdiagnosed by primary care providers (PCPs). We describe a case report of vulvar AA in a 38-year-old woman who underwent complete surgical excision of the neoplasm with no evidence of recurrence on a 5-year followup. A literature review follows to provide PCPs with the clinical, radiologic, and pathologic features that this tumor displays. PMID:24073346

Elkattah, R; Sarkodie, O; Otteno, H; Fletcher, A

2013-01-01

10

A Case of Sparganosis That Presented as a Recurrent Pericardial Effusion  

PubMed Central

Sparganosis is caused by a larval tapeworm of the genus Spirometra, which commonly invades subcutaneous tissue, but less frequently invades muscle, intestines, spinal cord, and the peritoneopleural cavity. The authors managed a female patient who presented with a recurrent pericardiopleural effusion and peripheral eosinophilia. The anti-sparganum-specific IgG serum level was significantly higher than normal control levels. In this patient, sparganosis was caused by the ingestion of raw frogs in an effort to control her thyroid disease. The recurrent pericardiopleural effusion and peripheral eosinophilia were controlled by 3 consecutive doses of praziquantel (75 mg/kg/day). The patient is doing well 4 years after presentation. Sparganosis should be considered a rare, but possible cause of recurrent pericardial effusion and peripheral eosinophilia. Immunoserologic testing using enzyme linked immunosorbent assays can be helpful in diagnosing human sparganosis, especially in cases without a subcutaneous lump or mass. Praziquantel is an alternative treatment for sparganosis in surgically-unresectable cases. PMID:21359068

Lee, Ju-Hee; Kim, Gi-Hyun; Kim, Sang Min; Lee, Sang Yeub; Lee, Won-Yik; Shin, Kyung-Sub; Hwang, Kyung-Kuk; Kim, Dong-Won; Cho, Myeong-Chan

2011-01-01

11

Axillary sparganosis which was misunderstood lymph node metastasis during neoadjuvant chemotheraphy in a breast cancer patient.  

PubMed

Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection. PMID:25485243

Lee, Eun Kyoung; Yoo, Young Bum

2014-12-01

12

Axillary sparganosis which was misunderstood lymph node metastasis during neoadjuvant chemotheraphy in a breast cancer patient  

PubMed Central

Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection. PMID:25485243

Lee, Eun Kyoung

2014-01-01

13

Carvenous lymphangioma of the vulva  

PubMed Central

Lymphangioma is a rare proliferation of the lymphatic system which is classified as either lymphangioma circumscription or carvenous lymphangioma. The involvement of the vulva is very rare and only a small number of case reports have been made on carvenous lymphangioma of the vulva. We herein report a case of 20-year-old unmarried girl presented with gradually expanding and painless tumor of the left labium majus. The mass was removed surgically and pathology confirmed as carvenous lymphangioma, with no recurrences to date. PMID:25629024

Yoon, Kyung-Ran; Mo, A-Jin; Na, Yeon Sik; Park, Sung Taek

2015-01-01

14

Carvenous lymphangioma of the vulva.  

PubMed

Lymphangioma is a rare proliferation of the lymphatic system which is classified as either lymphangioma circumscription or carvenous lymphangioma. The involvement of the vulva is very rare and only a small number of case reports have been made on carvenous lymphangioma of the vulva. We herein report a case of 20-year-old unmarried girl presented with gradually expanding and painless tumor of the left labium majus. The mass was removed surgically and pathology confirmed as carvenous lymphangioma, with no recurrences to date. PMID:25629024

Yoon, Kyung-Ran; Mo, A-Jin; Park, Sung-Ho; Na, Yeon Sik; Park, Sung Taek

2015-01-01

15

Development of a rapid diagnostic kit that uses an immunochromatographic device to detect antibodies in human sparganosis.  

PubMed

A diagnostic kit using an immunochromatographic device was developed to replace the time-consuming immunodiagnostic methods for human sparganosis. The kit was found to be faster and easier to use than an enzyme-linked immunosorbent assay (ELISA) and showed higher sensitivity and specificity. It will be useful for the laboratory diagnosis of hospitalized cases of sparganosis. PMID:24990912

Yamasaki, Hiroshi; Nakamura, Takeshi; Intapan, Pewpan M; Maleewong, Wanchai; Morishima, Yasuyuki; Sugiyama, Hiromu; Matsuoka, Hiroyuki; Kobayashi, Kaoru; Takayama, Katsuyoshi; Kobayashi, Yukuharu

2014-09-01

16

Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant  

PubMed Central

We report a case of subcutaneous sparganosis in a 68-year-old female Japanese immigrant in Germany. The patient complained of a painless erythema caudal of the umbilicus with a palpable subcutaneous cherry-sized lump. Polymerase chain reaction on formalin-fixed parasite tissue identified Spirometra erinaceieuropaei as the causative agent; the proliferative form of sparganosis, which is caused by the branching and disseminating Sparganum proliferum, could, thus, be excluded. From the excised sparganum, an immunofluorescence test was established and revealed an antibody response directed against the parasite's tegument. Histological key features of the plerocercoid that facilitate diagnosis with different stains are presented. PMID:23166198

Tappe, Dennis; Berger, Luise; Haeupler, Alexandra; Muntau, Birgit; Racz, Paul; Harder, Yves; Specht, Katja; Prazeres da Costa, Clarissa; Poppert, Sven

2013-01-01

17

Misdiagnosed gastrinoma: A case report.  

PubMed

Gastrinoma is most commonly located in the gastrinoma triangle (comprising of the duodenum, pancreas and bile ducts) or in the adjacent lymph nodes. Due to the low mortality rate, it is often misdiagnosed as other diseases with similar clinical characteristics, such as a solid pseudopapillary tumor of the pancreas (SPTP). Therefore, the current study reports a rare case of gastrinoma located in the tail of the pancreas of a female patient under medical examination, who exhibited no clinical symptoms. The tumor, which was located in the body and tail of the pancreas, was successfully resected and the spleen was preserved. The outcome of surgery combined with the postoperative pathological examination resulted in the patient being misdiagnosed with a SPTP. During the consequent six-year follow-up period, low-density liver lesions and an intractable peptic ulcer gradually appeared. Finally, the patient diagnosis was confirmed as a malignant pancreatic neuroendocrine carcinoma with liver metastases. On June 1, 2011, a liver transplant was successfully performed and the patient has maintained a good overall condition. The underlying clinical and pathological factors that may have resulted in misdiagnosis are investigated in the present study. Through providing our preliminary clinical experiences and lessons, the aim of the present study was to focus the attention of clinicians on this type of cancer in order to improve its diagnosis and treatment. PMID:24932294

Sun, Qi-Kai; Wang, Wei; Zhou, Hang-Cheng; Lv, Yang; Yu, Ji-Hai; Ma, Jin-Liang; Jia, Wei-Dong; Xu, Ge-Liang

2014-06-01

18

Migration of sparganosis from the brain to the cervical spinal cord.  

PubMed

Central nervous system (CNS) sparganosis is a rare parasitic infestation caused by ingestion of the raw or inadequately cooked snakes or frogs. Sparganum is well known for its ability of migrating though the tissue, therefore, it can cause various neurological symptoms if it involves neurological systems. A 51-year-old male patient visited our department of neurosurgery complaining of the motor weakness and radiating pain on both upper extremities over 4 months. He had a history of ingesting raw snakes untill his late twenties. The magnetic resonance (MR) images of cervical spine revealed an intramedullary ill-defined enhancing lesion with the aggregated cysts in the upper cervical spinal cord. Under presumptive diagnosis of sparganosis, we took brain MR image. The brain MR images revealed the signal change in right fronto-temporal lobe suggesting the trajectory of parasitic migration via ventricular systems. He underwent a midline myelotomy and granuloma removal followed by the posterior laminoplasty. Pathologic findings showed inflammatory changes and necrosis with keratinized tissue suggesting the CNS sparganosis. We report an uncommon case of CNS sparganosis migrated from the brain to the spinal cord with literature review. PMID:22639717

Jang, Se Youn; Kim, Choong Hyun

2012-03-01

19

Retrospective epidemiological analysis of sparganosis in mainland China from 1959 to 2012.  

PubMed

In this study, epidemiological factors of sparganosis cases reported in mainland China from 1959 to December 2012 were analysed. A total of 1061 valid cases were distributed throughout most of the provinces of mainland China, with most cases occurring in Southern and Eastern China. The average age of patients was 29 years (range 0-80 years). Modes of transmission to humans were via contact (54·6%), mainly by application of frog meat as a poultice, foodborne (33·8%), mainly through ingesting frogs or snakes, and waterborne (11·5%) through drinking raw water. The tissue/organs involved were subcutaneous/muscle (43·1%), eyes (31·0%), central nervous system (CNS) (17·9%), urogenital system (3·9%) and visceral organs (3·2%). Obvious differences existed in main risk factors for different areas. Close correlation was found between tissue/organs and risk factors. Main modes of transmission changed during the past decades, from contact (83·8% pre-1979) to foodborne (63·9% post-2000). The tissue/organs involved also changed at the same time. Cases involving eyes fell from 50·0% pre-1979 to 8·3% post-2000, and cases involving CNS increased from 0% pre-1979 to 47·8% post-2000. These results illustrate that China is one of the main epidemic countries of sparganosis in the world. Consumption of frog/snake meat was the main risk factor, although application of frog flesh as a poultice was the main risk factor before 2000. Sparganosis has become one of the neglected but important foodborne/waterborne parasitic diseases in mainland China. PMID:25372227

Lu, G; Shi, D-Z; Lu, Y-J; Wu, L-X; Li, L-H; Rao, L-Y; Yin, F-F

2014-12-01

20

Verruciform xanthoma of the vulva: case report.  

PubMed Central

A rare case of verruciform xanthoma of the vulva is reported. Diagnosis was made possible by histopathological examination and immunohistochemical staining. Verruciform xanthomas generally occur in the oral cavity. To the best of our knowledge, this is the third reported case of the tumour located on the genital mucosa. Immunohistochemical study supported the histiocytic origin of the lesion. Clinically, verruciform xanthomas may mimic other verrucous lesions of the vulva, such as seborrhoeic keratosis, verruca simplex, condyloma acuminatum, verrucous carcinoma, or erythropasia of Queyrat, or conditions such as histiocytosis, cutaneous lipidosis, or granular cell myoblastoma. The characteristics that differentiate those conditions from verruciform xanthoma, which can be seen only on histology, are given. Images PMID:2807284

de Rosa, G; Barra, E; Gentile, R; Boscaino, A; Di Prisco, B; Ayala, F

1989-01-01

21

Recurrent verruciform xanthoma of the vulva.  

PubMed

Verruciform xanthoma is a rare, benign, mucocutaneous, nondestructive lesion characterized by proliferation of non-Langerhans lipid-rich histiocytes. We describe the clinical and pathologic findings in a 30-year-old female with recurrent verruciform xanthoma of the vulva 8 years after initial therapy. The differential diagnosis includes seborrheic keratosis, verruca simplex, condyloma acuminatum, granular cell myoblastoma, vulvar intraepithelial neoplasia, bowenoid papulosis, erythroplasia of Queyrat, and verrucous carcinoma. PMID:14668556

Reich, Olaf; Regauer, Sigrid

2004-01-01

22

Primary milia localized to the vulva.  

PubMed

Multiple primary milia were found on the vulva of a 52-year-old woman who was referred to the dermatology clinic by her gynecologist. These lesions are commonly distributed on the face and rarely occur in this location without antecedent trauma. This report demonstrates the unique presentation of primary milia in the genital region and explores the diagnostic features and treatment methods of these lesions. PMID:24746302

Adotama, Prince; Susa, Joseph; Glass, Donald A

2014-01-01

23

Malignant spiradenoma/cylindroma of the vulva.  

PubMed

Malignant spiradenoma/cylindroma of the vulva is an extremely rare adnexal tumor. We report the clinicopathological features of a 58-year-old woman who presented with malignant spiradenoma/cylindroma originating in the vulva and metastasized to the inguinal lymph nodes. Surgical excision with adequate margins and lymph node dissection was performed. Sections from the case were stained with Periodic Acid Schiff stain before and after diastase. Immunohistochemical study of the case using antibodies to carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin5/6 (CK 5/6), p63, cytokeratin7 (CK 7), smooth muscle actin (SMA), and S100 were performed. Microscopic examination revealed that spiradenoma nodules were positive to EMA and CEA. However, the cylindroma lobules showed strong immunoreactivity to p63 and CK5/6, whereas both tumor components were negative to S100, SMA, and CK7. Malignant spiradenoma/cylindroma is a rare tumor with controversial histogenesis that should be considered in the differential diagnosis of primary adnexal carcinoma and secondary metastatic tumors in the vulva. Further studies on a wider cohort should be encouraged. PMID:23147883

Emam, Eman E; Sawan, Ali S; Al-Tamimi, Soha R; Molah, Rihab M

2012-11-01

24

Wnt signaling induces vulva development in the nematode Pristionchus pacificus.  

PubMed

The Caenorhabditis elegans vulva is induced by a member of the epidermal growth factor (EGF) family that is expressed in the gonadal anchor cell, representing a prime example of signaling processes in animal development. Comparative studies indicated that vulva induction has changed rapidly during evolution. However, nothing was known about the molecular mechanisms underlying these differences. By analyzing deletion mutants in five Wnt pathway genes, we show that Wnt signaling induces vulva formation in Pristionchus pacificus. A Ppa-bar-1/beta-catenin deletion is completely vulvaless. Several Wnt ligands and receptors act redundantly in vulva induction, and Ppa-egl-20/Wnt; Ppa-mom-2/Wnt; Ppa-lin-18/Ryk triple mutants are strongly vulvaless. Wnt ligands are differentially expressed in the somatic gonad, the anchor cell, and the posterior body region, respectively. In contrast, previous studies indicated that Ppa-lin-17, one of the Frizzled-type receptors, has a negative role in vulva formation. We found that mutations in Ppa-bar-1 and Ppa-egl-20 suppress the phenotype of Ppa-lin-17. Thus, an unexpected complexity of Wnt signaling is involved in vulva induction and vulva repression in P. pacificus. This study provides the first molecular identification of the inductive vulva signal in a nematode other than Caenorhabditis. PMID:18207741

Tian, Huiyu; Schlager, Benjamin; Xiao, Hua; Sommer, Ralf J

2008-01-22

25

A case of misdiagnose of malaria infection.  

PubMed

A case of malaria infection in a 42-year-old woman in rural area of Mahmodabad, Mazandaran Province, North Iran was reported and discussed elaborately. She was complaining about recurrent fevers, sweating, headache and myalgia in back. After her first admission to hospital due to misdiagnose she did not receive proper treatment and the patient suffered from clinical manifestations again. Eventually in the second admission to another hospital, after a precise examination on her thick and thin blood smear the agent of disease was recognized appropriately as Plasmodium vivax and treated accordingly. PMID:23998018

Ali, Mahdavi Seif; Ahmad, Raeesi; Leyla, Faraji; Reza, Youssefi Mohammad; Taghi, Rahimi Mohammad

2013-09-01

26

Recurrent vulvovaginal candidosis: focus on the vulva.  

PubMed

Recurrent vulvovaginal candidosis is a frequent disease with a serious impact on women's quality of life. Mostly, recurrences are caused by identical Candida strains suggesting C. albicans persistence in the female anogenital area. Objectives of the presented work were to identify the site of C. albicans persistence, to determine clinical symptoms and signs related to C. albicans positive vulvar cultures and to introduce a new therapeutic approach in women with RVVC. Women with an acute, culture-confirmed episode of RVVC at time of visit were included in this prospective case series. Swabs were obtained from both vagina and inter-labial sulcus. Women received a combined 20-day regimen of 100 mg oral fluconazole and ciclopiroxolamin cream topically. Follow-up visits were at 3, 6, 9 and 12 months. Of 139 women, 105 (76%) had at least one C. albicans positive culture from the external vulva. Vulvar positive cultures correlated with pruritus (OR 5.4; P < 0.001), vulvar edema (OR 3.8; P = 0.03) and fissures (OR 2.4; P = 0.03). Recurrence rates were 27%, 33% and 34% (at 6, 9, 12 months, respectively). The external vulva appears to represent a site of C. albicans persistence and source of endogenous re-infection in patients with RVVC. The combined treatment compared favorably with published fluconazole maintenance regimens. PMID:21615545

Beikert, Florian C; Le, Minh T; Koeninger, Angela; Technau, Kristin; Clad, Andreas

2011-11-01

27

Acute vulvar pain in a lady with post circumcision inclusion cyst of the vulva containing stones: a case report  

PubMed Central

Background Despite global eradication efforts, female genital cutting is still deep routed practice in some parts of Asia and East Africa. The crude and unscientific natures of the practice lead to many complications. Epidermoid inclusion cysts of the vulva are one of the late complications of female genital cutting and typically present as painless cystic swellings. But clinical presentation as ‘stone’ containing, hard vulvar mass is reported only once in the literature and presentation with acute vulvar pain has never been documented. Case presentation A 21 yrs old, Ethiopian, unmarried, lady presented with sever acute vulvar pain, discharge, and a stony hard vulvar swelling 13 years after type-III female genital cutting (infibulation). Surgical excision of the cyst, which contained two ‘stones’ inside it, and defibulation were done. Histopathology confirmed calcified, keratinizing epidermoid inclusion cyst of the vulva. Conclusions Clinicians, in areas where female genital cutting is prevalent, should be aware of such unusual late vulvar complication of the practice which might be misdiagnosed for other solid vulvar swellings and be familiar with the appropriate management. PMID:24387298

2014-01-01

28

Cases of pediatric narcolepsy after misdiagnoses.  

PubMed

Narcolepsy is characterized by recurrent brief attacks of irresistible sleepiness. Signs can begin during childhood. However, diagnoses are frequently delayed by 10-15 years because of unfamiliarity with pediatric narcolepsy and variable presentations of its associated features (cataplexy, hypnagogic/hypnopompic hallucinations, and sleep paralysis). Therefore, patients may remain untreated during their formative years. Three children with narcolepsy who were initially misdiagnosed are described. Each child's signs were initially related to depression, hypothyroidism, jaw dysfunction, or conversion disorder. However, after a multiple sleep latency test, the diagnosis of narcolepsy was established. All three patients were treated appropriately with stimulant medications, selective serotonin reuptake inhibitors, or sodium oxybate, and demonstrated positive responses. Although no definitive cure exists for narcolepsy, early recognition and appropriate symptomatic treatment with medications can allow affected children to improve quality of life and achieve normality, both academically and socially. PMID:23044019

Kauta, Shilpa R; Marcus, Carole L

2012-11-01

29

Autoimmune Lymphoproliferative Syndrome Misdiagnosed as Hemophagocytic Lymphohistiocytosis  

PubMed Central

Autoimmune lymphoproliferative syndrome (ALPS) is a rare inherited disorder of apoptosis, most commonly due to mutations in the FAS (TNFRSF6) gene. It presents with chronic lymphadenopathy, splenomegaly, and symptomatic multilineage cytopenias in an otherwise healthy child. Unfortunately, these clinical findings are also noted in other childhood lymphoproliferative conditions, such as leukemia, lymphoma, and hemophagocytic lymphohistiocytosis, which can confound the diagnosis. This report describes a 6-year-old girl with symptoms misdiagnosed as hemophagocytic lymphohistiocytosis and treated with chemotherapy before the recognition that her symptoms and laboratory values were consistent with a somatic FAS mutation leading to ALPS. This case should alert pediatricians to include ALPS in the differential diagnosis of a child with lymphadenopathy, splenomegaly, and cytopenias; obtain discriminating screening laboratory biomarkers, such as serum vitamin B-12 and ferritin levels; and, in the setting of a highly suspicious clinical scenario for ALPS, pursue testing for somatic FAS mutations when germ-line mutation testing is negative. PMID:24101757

Rudman Spergel, Amanda; Walkovich, Kelly; Price, Susan; Niemela, Julie E.; Wright, Dowain; Fleisher, Thomas A.

2013-01-01

30

Evolution of Vulva Development in the Cephalobina (Nematoda)  

Microsoft Academic Search

Ventral cord and vulva development are analyzed in a large sample of nematode species of the suborder Cephalobina. We find a specific range of evolutionary variations at distinct developmental steps. (1) Unlike Caenorhabditis elegans and relatives, the vulva is formed from the four precursor cells P(5–8).p or, exceptionally, from P(6,7).p only. (2) The vulval competence group is restricted to these

Marie-Anne Félix; Paul De Ley; Ralf J. Sommer; Linda Frisse; Steven A. Nadler; W. Kelley Thomas; Jacques Vanfleteren; Paul W. Sternberg

2000-01-01

31

Rare sweat gland tumors of vulva: Report of two cases  

PubMed Central

Syringomas and Fox–Fordyce disease are appendageal skin disorders. While syringomas represent an adenoma of the intraepidermal eccrine duct, Fox Fordyce disease occurs due to blockage of the apocrine sweat duct. In both conditions, extragenital sites are more frequently involved than the genitalia. We herein report two young females, one with syringomas on the face and vulva and the other with Fox Fordyce disease involving axilla, areola and vulva, thereby citing the importance of examination of genitalia in these disorders. PMID:23188940

Mahajan, Rashmi; Bang, Damodar; Nagar, Amit; Bilimoria, Freny

2012-01-01

32

Tinea capitis favosa misdiagnosed as tinea amiantacea  

PubMed Central

Introduction Favus of the scalp or tinea capitis favosa is a chronic dermatophyte infection of the scalp. In almost cases, favus is caused by Trichophyton schoenleinii, anthropophilic dermatophyte. It is characterized by the presence of scutula and severe alopecia. Besides the classic clinical type of tinea capitis favosa, there are many variant of clinical form which may persist undiagnosed for many years. In this work, we report an atypical form of favus to Trichophyton schoenleinii which was misdiagnosed as tinea amiantacea. Case-report An 11-year old girl came to the outpatient department of dermatology (day 0) with history of tinea amiantacea treated unsuccessfully with keratolytic shampoo (day – 730). She presented a diffuse scaling of the scalp with thick scaly patches and without scutula or alopecia. A diagnosis of tinea favosa by T. schoenleinii was made by mycological examination. She was treated with griseofulvin and ketoconazole in the form of foaming gel for twelve weeks. Despite treatment, clinical evolution was marked by appearance of permanent alopecia patches. The follow-up mycological examination was negative. Conclusion Because of ultimate evolution of favus into alopecia, we emphasize the importance of mycological examination in case of diffuse scaling. PMID:24432210

Anane, Sonia; Chtourou, Olfa

2012-01-01

33

Sparganosis Presenting as Cauda Equina Syndrome with Molecular Identification of the Parasite in Tissue Sections  

PubMed Central

A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei. PMID:24516282

Boonyasiri, Adhiratha; Cheunsuchon, Pornsuk; Srirabheebhat, Prajak; Yamasaki, Hiroshi; Maleewong, Wanchai

2013-01-01

34

Cutaneous lymphangiectasia of the vulva secondary to tuberculosis  

PubMed Central

Cutaneous lymphangiectasia, also called as acquired lymphangioma, is a benign cutaneous disorder involving the dermal and subcutaneous lymphatic channels. It can rarely occur on the vulva. We describe a 35-year-old woman who came with multiple raised lesions over the vulva and left upper thigh of 1 year duration. She gave history of getting treated for multiple swellings that developed over right side of the neck and inguinal regions on both sides three decades ago. On local genital examination, the patient had a large polypoidal growth involving both sides of the vulva, left upper thigh, and over pubic area. Multiple linear scars were present over the upper thighs and groin bilaterally. The patient underwent simple vulvectomy and left thigh growth excision. Histopathological examination of the vulvectomy specimen confirmed our diagnosis. PMID:22529452

Bhat, Ramesh M.; Saldanha, Celia S.; Kambil, Srinath M.; Dandakeri, S.

2012-01-01

35

Recurrent necrotizing fasciitis of the vulva. A case report.  

PubMed

Necrotizing fasciitis most often occurs in the context of prior trauma or surgery. Predisposing medical conditions include diabetes mellitus, arteriosclerosis, obesity, hypertension and prior irradiation. De novo occurrence in the vulva, in the absence of prior injury, surgery or irradiation, has been reported rarely. Necrotizing fasciitis of the vulva in the diabetic patient may have an insidious onset but requires an early diagnosis and aggressive surgical episode of fasciitis occurred in an obese, diabetic woman. Aggressive, wide excision of all infected vulvar, mons and thigh tissue, followed by aggressive medical and surgical postoperative care, resulted in minimal morbidity. Prompt recognition and aggressive care are required to treat this condition. PMID:1765962

Adelson, M D; Joret, D M; Gordon, L P; Osborne, N G

1991-11-01

36

Phyllodes tumor of vulva: a brief diagnostic review.  

PubMed

Phyllodes tumors of the vulva are rare proliferations that share morphologic similarities with breast neoplasms. Their histogenetic origin is elusive and may be associated with specialized mammary-like glands of the vulva. Because of their rarity, the clinical and pathologic features, classification, and therapy are not well defined, and their biologic behavior is difficult to predict by histology alone. Immunohistochemical expression of estrogen and progesterone receptors and breast markers provide further support for a common origin. Surgical resection is the current mainstay of therapy and is definitive in most cases. PMID:25357118

Lee, Solomon; Nodit, Laurentia

2014-11-01

37

Giant fibroepithelial stromal polyp of the vulva: largest case reported  

PubMed Central

Background Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made. Case We present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date. Conclusion Fibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis. PMID:23842282

2013-01-01

38

Huge filarial elephantiasis vulvae in a Nigerian woman with subfertility.  

PubMed

Filariasis is a helminthic infection caused by tissue nematodes. It is estimated that at least 120 million people are infected worldwide and another 1 billion are "at risk" of infection. The prevalence is increasing due to uncontrolled urbanization in many of the endemic countries. The geographical distribution is determined mainly by climate and the distribution of the mosquito vector. We report a case of huge filarial elephantiasis of the vulva, in a 40-year-old multipara with background history of secondary infertility. She had excision of the elephantoid vulva lesion under general anaesthesia. A nontender irreducible pedunculated mass (25 cmx21 cm) with a large stalk arising from the right groin down to the ipsilateral labia majora was removed. A similar mass on the left groin, measuring 10 cmx6 cm was removed. Diagnosis was confirmed at histopathologic analysis of the excised masses. Patient was placed on diethyl carbamazine. PMID:18368416

Adesiyun, Adebiyi Gbadebo; Samaila, Modupeola Omotara

2008-12-01

39

Aortoesophageal fistula: a case misdiagnosed as esophageal polyp.  

PubMed

Aortoesophageal fistula (AEF) is a rare and fatal disorder. It is also a life-threatening cause of massive upper gastrointestinal hemorrhage. Thoracic aortic aneurysm is the most common cause of AEF. Management of a patient with this disorder requires rapid diagnosis and immediate intervention, which is considered the best way to save the patient's life. We report a case of AEF misdiagnosed as esophageal polyp. PMID:20014468

Jiao, Yue; Zong, Ye; Yu, Zhong-Lin; Yu, Yong-Zheng; Zhang, Shu-Tian

2009-12-21

40

Aortoesophageal fistula: A case misdiagnosed as esophageal polyp  

PubMed Central

Aortoesophageal fistula (AEF) is a rare and fatal disorder. It is also a life-threatening cause of massive upper gastrointestinal hemorrhage. Thoracic aortic aneurysm is the most common cause of AEF. Management of a patient with this disorder requires rapid diagnosis and immediate intervention, which is considered the best way to save the patient’s life. We report a case of AEF misdiagnosed as esophageal polyp. PMID:20014468

Jiao, Yue; Zong, Ye; Yu, Zhong-Lin; Yu, Yong-Zheng; Zhang, Shu-Tian

2009-01-01

41

Update in Cancer Chemotherapy: Genitourinary Tract Cancer, Part 6: Cancer of the Uterus and Vulva  

PubMed Central

An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 6 is a review of treatment for cancers of the uterus and vulva. PMID:3292776

Wright, Jane C.

1988-01-01

42

Nonreentrant supraventricular tachycardia misdiagnosed as inappropriate sinus tachycardia.  

PubMed

We report a case of a woman with incessant palpitations initially misdiagnosed as inappropriate sinus tachycardia that proved refractory to ?-blockers. At the time of electrophysiologic testing, a sustained narrow-complex tachycardia with a 1:2 atrioventricular relationship was repeatedly initiated by a posterior fascicle depolarization induced by means of a timed ventricular extrastimulus. The tachycardia was repeatedly terminated with a timed atrial extrastimulus, which excluded junctional bigeminy and confirmed the diagnosis of nonreentrant supraventricular tachycardia. Catheter ablation of the slow pathway eliminated dual-pathway conduction and tachycardia. PMID:20487362

Bhatt, Advay G; Monahan, Kevin M

2011-08-01

43

A case of apical fenestration misdiagnosed as persistent apical periodontitis.  

PubMed

We report a case of apical fenestration misdiagnosed as persistent apical periodontitis. The patient was a 55-year-old woman who presented with persistent tooth pain at the right maxillary canine, despite repeated root canal treatment by a general practitioner. When the patient visited Tokyo Dental College Suidobashi Hospital, a CT examination was performed and apical fenestration diagnosed. The patient received an apicoectomy after which the symptoms disappeared. This suggests that dentists should consider the possibility of apical fenestration when examining patients with persistent tooth pain after repeated root canal treatment. PMID:22452888

Furusawa, Masahiro; Hayakawa, Hiroki; Ida, Atsushi; Ichinohe, Tatsuya

2012-01-01

44

Involuntary movements misdiagnosed as seizure during vitamin B12 treatment.  

PubMed

Seizures and epilepsy are a common problem in childhood. Nonepileptic paroxysmal events are conditions that can mimic seizure and frequent in early childhood. Nonepileptic paroxysmal events can be due to physiological or exaggerated physiological responses, parasomnias, movement disorders, behavioral or psychiatric disturbances, or to hemodynamic, respiratory, or gastrointestinal dysfunction. Vitamin B12 deficiency is a treatable cause of failure to thrive and developmental regression, involuntary movements, and anemia. Involuntary movements rarely may appear a few days after the initiation of vitamin B12 treatments and might be misdiagnosed as seizure. Here, we report 2 patients who presented with involuntary movements with his video image. PMID:24196096

Carman, Kursat Bora; Belgemen, Tugba; Yis, Uluc

2013-11-01

45

The Endemic Mimic: Blastomycosis An Illness Often Misdiagnosed  

PubMed Central

One of the endemic fungi, Blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. Blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lung. Extrapulmonary infection with B. dermatitidis is protean with many different manifestations. Most commonly, skin or subcutaneous lesions are found with either a verrucous or warty appearance or in an ulcerative form. Cases have been misidentified as keratoacanthoma, pyoderma gangrenosum, carcinoma, or as Weber-Christian panniculitis if there are nodular subcutaneous lesions. Essentially any site or organ can have lesions of disseminated blastomycosis. In our series, cases of laryngeal carcinoma, adrenal insufficiency, thyroid nodules, granulomatous hypercalcemia, abnormal mammograms thought to represent breast carcinoma, otitis media with cranial extension, immune thrombocytopenic purpura, and hemolytic anemia of unknown cause have been misdiagnosed and blastomycosis subsequently identified as the cause. This infection causes manifestations which mimic many other more commonly diagnosed conditions and must always be considered by clinicians practicing in the endemic region. PMID:25125734

Bradsher, Robert W.

2014-01-01

46

Paget's Disease of the Vulva in Premenopausal Woman Treated with Only Surgery: A Case Report  

PubMed Central

Paget's disease of the vulva remains a rare condition with only a limited number of cases reported in the literature. It is an uncommon neoplasm usually of postmenopausal white women characterized by controversies in its prevalence, clinical features, treatment strategies, and prognostic. We here report a case of a primary Paget's disease of the vulva in premenopausal woman treated by only surgery with a favorable issue. PMID:23024871

Asmouki, Hamid; Oumouloud, Rachid; Aboulfalah, Abderrahim; Soummani, Abderraouf; Marrat, Abdelouahed

2012-01-01

47

Keratocystic odontogenic tumour (KCOT) misdiagnosed as a dentigerous cyst  

PubMed Central

Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40?years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed. PMID:23429028

Chaudhary, Seema; Sinha, Ashish; Barua, Pranamee; Mallikarjuna, Rachappa

2013-01-01

48

Angiogenesis in Paget's Disease of the Vulva and the Breast: Correlation with Microvessel Density  

PubMed Central

Our understanding of the pathogenesis of Paget's disease of the vulva and the breast remains limited. Current evidence supports the fact that angiogenesis plays an important role in the pathogenesis of several diseases. Therefore, we sought to define its role, as correlated with microvessel density, in Paget's disease of the vulva and the breast. Microvessels were analysed using anti-von Willebrand factor antibody in 105 cases of Paget's disease of the vulva and the breast comprising 71 cases of Paget's disease of the vulva, including 8 cases with invasive disease, and 34 cases of Paget's disease of the breast. The latter included 12 cases with DCIS, 5 cases with both DCIS and invasive carcinoma, and 6 with carcinoma alone. Eleven cases had no underlying tumour identified. Increased microvessel density was demonstrated in Paget's disease of the breast with DCIS and with carcinoma alone compared to Paget's disease of the breast alone, P < 0.08 and P < 0.013, respectively. There were no significant differences in microvessel density in the vulval cases. Neovascularisation is an important process in the development of Paget's disease of the breast. Other biological and molecular processes are more involved in the pathogenesis of Paget's disease of the vulva. PMID:22545050

Ellis, Patricia E.; MacLean, Allan B.; Wong Te Fong, L. F.; Crow, Julie C.; Perrett, Christopher W.

2012-01-01

49

[Dystrophy and precancerous changes in the vulva: symptoms, histology and therapy].  

PubMed

The article reports about the relatively rare diseases kraurosis vulvae (lichen sclerosus et atrophicus) and leucoplakia vulvae and the symptoms, aetiology, histology and therapy of these diseases. Both diseases are considered to be a "dystrophy" since 1976, by international convention. This publication is a report on 168 patients treated during the last 20 years (1964-1983). 34 patients suffered from diabetes mellitus (21%); 73.2% of the women were aged between the 61st and 90th year of life. 15 women already had an incipient vulvar carcinoma besides kraurosis (8.9%). Precancerous alterations, such as morbus Bowen (29 cases), morbus Paget of the vulva (6 cases), and erythroplasia of Queyrat are subsequently discussed. PMID:2989078

Weghaupt, K

1985-05-01

50

Trends in Squamous Cell Carcinoma of the Vulva: The Influence of Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Objective: To determine trends in the clinicopathology of vulvar squamous cell carcinoma over the past 2 decades, with particular reference to the possible effects of the increasing incidence of vulvar intraepithelial neoplasia (VIN) during this time.Methods: Two cohorts of 56 and 57 women with squamous cell carcinoma of the vulva and separated by at least 2 decades were reviewed retrospectively.

R. W Jones; Judith Baranyai; S Stables

1997-01-01

51

Extramammary Paget's disease of the vulva: An annotated review of the current literature.  

PubMed

Extramammary Paget's disease is a rare and unusual neoplastic entity that presents mainly on apocrine gland-bearing skin. The vulva is the most common site of involvement but any area of the anogenital skin can be affected. Due to its rarity, variable clinical course and deceptive histological appearance it has a high misdiagnosis rate and both gynaecologists and dermatologists have limited experience in its management. The significance of the disease lies in its association with underlying malignancy as well as its inherent ability to invade the dermis and metastasise. The management is notoriously complicated and recurrence rates are high despite aggressive surgeries. Several alternative modalities are being explored, with results that are often variable and unpredictable. This review summarises the histopathological, clinical and therapeutic features of extramammary Paget's disease of the vulva reported in recent years. PMID:22671146

Delport, Elsie Sophia

2013-02-01

52

Spindle cell carcinoma of the vulva: a series of 4 cases and review of the literature.  

PubMed

Spindle cell or sarcomatoid squamous cell carcinoma is an uncommon variant of squamous cell carcinoma of the vulva (SCCV) with only 12 well-documented cases reported to date. Morphologically tumors may be biphasic or monophasic, and uncommonly include heterologous elements. Only 1 reported vulval tumor has previously been investigated for human papillomavirus DNA content. We describe 4 women with spindle cell (sarcomatoid) SCCV, 3 of which occurred de novo and 1 followed radiotherapy for previous SCCV. The tumors in all 4 women arose in a background of lichen sclerosus, and 3 were associated with vulval intraepithelial neoplasia differentiated (simplex) type. All tumors were negative for human papillomavirus DNA on polymerase chain reaction analysis. One case is the second reported with malignant heterologous elements described in the vulva. These tumors seem to be more aggressive than conventional SCCV. PMID:24487477

Bigby, Susan M; Eva, Lois J; Jones, Ronald W

2014-03-01

53

Nematode Tango Milonguero - the C. elegans male's search for the hermaphrodite vulva.  

PubMed

The vulva search corresponds to the first step of mating in Caenorhabditis elegans wherein the male recognizes a potential mate through contact and commences a systematic, contact-based search of her surface for the vulva. During this 'dance' the male presses his tail genitalia firmly against the hermaphrodite surface and moves backward, modulating tail posture to effect changes in search trajectory. Upon sensing the vulva, the male pauses and the insemination phase of mating begins. External tail sensilla, the rays, induce and guide the male's search by registering hermaphrodite surface cues. C. elegans male mating behavior, like many other animate interactions (such as predator-prey interactions or intrasexual aggression), is performed at close quarters and requires that participants constantly adjust their movement with respect to one another on a moment-by-moment basis. The design features of the supporting circuitry explain simultaneously the robustness, speed and acuity of the male's behavior and its male-specific nature. Processing at all levels of the circuitry appears to be distributed. Cellular components exhibit both partial redundancy (thus conferring robustness in output) and subtle functional differences (predicted to confer acuity). Surprisingly, gender-shared cell types feature prominently in the circuitry. Male-specific components form sensory pathways that render downstream gender-shared circuits responsive to mate cues, while other male cells act to augment gender-shared cell activity. Overall, the attributes of the vulva search circuitry provide insight into principles guiding the design and operation of circuits supporting dynamic social behaviors expressed by more complex and less tractable animal species. PMID:24862858

Sherlekar, Amrita L; Lints, Robyn

2014-09-01

54

Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.  

PubMed

We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva. PMID:24342664

AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

2014-04-01

55

Over-interpretation of electroclinical and neuroimaging findings in syncopes misdiagnosed as epileptic seizures.  

PubMed

Syncope and epileptic seizures share some common clinical characteristics that may complicate the diagnostic process. In clinical practice, syncope is frequently misdiagnosed as an epileptic seizure and consequently treated with antiepileptic drugs. In this study, we identified 57 patients with syncope (diagnosis based on accepted criteria) who had come to our unit with a previous diagnosis of definite epilepsy in 30 cases (syncope misdiagnosed as epileptic seizures, SMS), or suspected epilepsy in the remaining 27 cases (unrecognized syncope, US). We attempted to identify factors underlying misdiagnosis by reviewing clinical findings, particularly potentially confounding features, and EEG/neuroimaging data. Finally, we compared these two groups of patients to search for crucial elements that had led to misdiagnosis. Although some clinical elements were found to be confounding in both groups, it was the interpretation of the EEG and MRI findings, particularly when combined with the confounding clinical features that constituted the main reasons for misdiagnosis. PMID:17525028

Fattouch, Jinane; Di Bonaventura, Carlo; Strano, Stefano; Vanacore, Nicola; Manfredi, Mario; Prencipe, Massimiliano; Giallonardo, Anna Teresa

2007-06-01

56

Congenital anomaly of the atlas misdiagnosed as posterior arch fracture of the atlas and atlantoaxial subluxation.  

PubMed

Partial or complete absence of the posterior arch of the atlas is a well-documented anomaly but a relatively rare condition. This condition is usually asymptomatic so most are diagnosed incidentally. There have been a few documented cases of congenital defects of the posterior arch of the atlas combined with atlantoaxial subluxation. We report a very rare case of congenital anomaly of the atlas combined with atlantoaxial subluxation, that can be misdiagnosed as posterior arch fracture. PMID:24605195

Park, Yung; Kim, Seong Min; Lee, Yun Tae; Yoo, Ju Hyung; Oh, Hyun Chul; Ha, Joong-Won; Sung, Seung Yong; Yoon, Han Kook; Chang, Jee-Hoon; Jung, Jeung-Yeul

2014-03-01

57

Intraosseous Hemangioma of the Middle Turbinate Misdiagnosed As a Nasal Polyp  

PubMed Central

Intraosseous hemangiomas account for 1% of all bone tumors and primarily originate from the vertebral column and skull bones. However, intraosseous hemangiomas of the nasal cavity are extremely rare. Here, we report a case of intraosseous hemangioma with a cavernous pattern arising from the middle turbinate that was preoperatively misdiagnosed as chronic rhinosinusitis with polyps. Except for nasal obstruction, there were no specific rhinologic symptoms. The tumor was excised en bloc by the endoscopic endonasal approach without preoperative embolization. PMID:25165592

Lim, Eun Jung; Lee, Jin Gul; Han, Man-Hoon

2014-01-01

58

Preliminary study on human papillomavirus frequency and specific type-distribution in vulva cancer from Thai women.  

PubMed

Vulva cancer is rare among all gynecological cancer worldwide, including Thailand, and mainly affects older women. Persistent high risk type infection of human papillomavirus (HPV) is the one important factor for developing cancer. In this study, we focused on HPV DNA investigation and type-specific distribution of HPV in 25 formalin-fixed paraffin-embedded (FFPE) samples collected from Thai women with vulva cancer histologically confirmed by the National Cancer Institute, Thailand, during 2003-2011. HPV DNA detection and genotyping were undertaken with polymerase-chain reaction and enzyme-immunoassay using GP5+/bio6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. Human ?-globin genes was used as the internal control. Our results showed that 44% (11/25) of all vulva cancer samples were HPV-positive. All of them are high risk HPV type infection, detected as single (63.64%, 7/11) and/or double infections (4/11, 36.36%). HPV 16 was the most common type identified in vulva cancer, followed by HPV 35, 33, 18 and 58. In conclusion, this study presented that HPV-16 is observed at the highest frequency in this cancer, similar to cervical cancer, with HPV 18 being less frequent. Although the sample size was small and could not represent overall incidence and prevalence in Thai women, these preliminary data for vulva cancer are of interest since they reinforce the necessity for HPV screening or vaccination in Thailand. PMID:23725140

Ngamkham, Jarunya; Homcha-Aim, Patcharin; Boonmark, Krittika; Phansri, Thainsang; Swangvaree, Sukumarn Snersak

2013-01-01

59

Two distinct pathways to development of squamous cell carcinoma of the vulva.  

PubMed

Squamous cell carcinoma (SCC) accounts for approximately 95% of the malignant tumors of the vaginal vulva and is mostly found in elderly women. The future numbers of patients with vulvar SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulvar SCC have been put forth. The first pathway is triggered by infection with a high-risk-type Human Papillomavirus (HPV). Integration of the HPV DNA into the host genome leads to the development of a typical vulvar intraepithelial neoplasia (VIN), accompanied with overexpression of p14(ARF) and p16(INK4A). This lesion subsequently forms a warty- or basaloid-type SCC. The HPV vaccine is a promising new tool for prevention of this HPV related SCC of the vulva. The second pathway is HPV-independent. Keratinizing SCC develops within a background of lichen sclerosus (LS) through a differentiated VIN. It has a different set of genetic alterations than those in the first pathway, including p53 mutations, allelic imbalances (AI), and microsatellite instability (MSI). Further clinical and basic research is still required to understand and prevent vulvar SCC. Capsule. Two pathway for pathogenesis of squamous cell carcinoma of the value are reviewed. PMID:21188235

Ueda, Yutaka; Enomoto, Takayuki; Kimura, Toshihiro; Yoshino, Kiyoshi; Fujita, Masami; Kimura, Tadashi

2011-01-01

60

Two Distinct Pathways to Development of Squamous Cell Carcinoma of the Vulva  

PubMed Central

Squamous cell carcinoma (SCC) accounts for approximately 95% of the malignant tumors of the vaginal vulva and is mostly found in elderly women. The future numbers of patients with vulvar SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulvar SCC have been put forth. The first pathway is triggered by infection with a high-risk-type Human Papillomavirus (HPV). Integration of the HPV DNA into the host genome leads to the development of a typical vulvar intraepithelial neoplasia (VIN), accompanied with overexpression of p14ARF and p16INK4A. This lesion subsequently forms a warty- or basaloid-type SCC. The HPV vaccine is a promising new tool for prevention of this HPV related SCC of the vulva. The second pathway is HPV-independent. Keratinizing SCC develops within a background of lichen sclerosus (LS) through a differentiated VIN. It has a different set of genetic alterations than those in the first pathway, including p53 mutations, allelic imbalances (AI), and microsatellite instability (MSI). Further clinical and basic research is still required to understand and prevent vulvar SCC. Capsule. Two pathway for pathogenesis of squamous cell carcinoma of the value are reviewed. PMID:21188235

Ueda, Yutaka; Enomoto, Takayuki; Kimura, Toshihiro; Yoshino, Kiyoshi; Fujita, Masami; Kimura, Tadashi

2011-01-01

61

Cutaneous manifestation of odontogenic infection misdiagnosed as having dermatologic etiology: a report of two cases.  

PubMed

General dentists should be aware that extraoral dental cutaneous lesions can be confused with dermatologic lesions. We report two cases of cutaneous lesions of dental origin that were initially misdiagnosed as being dermatologic in origin. Multiple treatments were performed, including plastic surgery, but the lesions did not resolve. Then, the lesions' dental etiology was identified. Endodontic intervention resulted in resolution of the problem, confirming the initial misdiagnosis. A dental etiology, as part of a differential diagnosis, should be kept in mind with orofacial skin lesions. PMID:21519581

Gupta, Saurabh Kumar; Saxena, Payal

2011-06-01

62

Arteriovenous Fistula of the Filum Terminale Misdiagnosed and Previously Operated as Lower Lumbar Degenerative Disease  

PubMed Central

Filum terminale arteriovenous fistula (FTAVF) presenting as a cause of failed back surgery syndrome is a rare entity. We report a 48-year-old male patient who presented with clinical features of a conus medullaris/cauda equina lesion. He had upper and lower motor neuron signs in both the lower limbs with autonomic dysfunction. The patient was misdiagnosed and was operated twice earlier for lumbar canal stenosis and disc prolapse. After reviewing his clinical and radiological findings a diagnosis of FTAVF was made. He underwent surgery and there was a significant improvement in his neurological functions. We discuss the case and review the literature on FTAVF's. PMID:24967053

Ranjan, Alok; Lath, Rahul

2014-01-01

63

Giant Angiokeratoma of Fordyce over the Vulva in a Middle-Aged Woman: Case Report and Review of Literature  

PubMed Central

Angiokeratoma of Fordyce occurring over vulva is rare. Angiokeratoma of Fordyce commonly occurs in males over scrotum or penile shaft and presents as multiple verrucous reddish papules. They are usually asymptomatic and noticed accidentally. In the present article, we present and review the literature of giant angiokeratoma of Fordyce in middle-aged women due to its rarity. PMID:23723496

Kudur, Mohan H; Hulmani, Manjunath

2013-01-01

64

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman's disease) previously misdiagnosed as Toxoplasma Lymphadenitis.  

PubMed

Here we describe a case of Rosai-Dorfman Disease (RDD) in a 25-year-old female patient from Turkey who was previously misdiagnosed with Toxoplasma Lymphadenitis, and review the manifestations and treatment of this rare entity. To the best of our knowledge this is the third description of RDD [Sinus Histiocytosis with Massive Lymphadenopathy (SHML)], involving bilateral cervical lymphadenopathy and nephromegaly previously misdiagnosed as Toxoplasma Lymphadenitis. Representative clinical, radiographic and histological findings are presented. Its etiology, diagnosis and management are also reviewed. Sinus Histiocytosis with Massive Lymphadenopathy is a rare disorder of unknown etiology, usually associated with lymph node enlargement in various superficial or deep sites. The key histologic feature of SHML is the presence of various numbers of large, pale histiocytic cells that contain within their cellular borders apparently engulfed lymphocytes (emperipolesis); these distinctive large, pale cells are S-100 protein positive CD-68 positive and CD1a negative by immunostaining. According to the literature the most effective treatment found was surgical debulking. PMID:15291364

Kara, Ismail O; Ergin, Melek; Sahin, Berksoy; Inal, Seza; Tasova, Yesim

2004-05-01

65

Pedunculated Angiomyofibroblastoma of the Vulva: Case Report and Review of the Literature  

PubMed Central

Angiomyofibroblastoma (AMFB) is a rare benign mesenchymal tumour that occurs almost exclusively in the vulvovaginal region of women but can also occur occasionally in the inguinoscrotal region of men. It is a well-circumscribed lesion that clinically is often thought to represent a Bartholin's gland cyst and usually does not form a pedunculated mass. To our knowledge, only five cases of vulvar AMFB with pedunculated mass have been reported in the English literature and all cases involving the labia majora and middle-aged women. We report the first case of pedunculated AMFB of the vulva occurring in a young woman of 21 years old and involving the left labia minora. After excluding the most common diseases, pedunculated AMFB should be part of differential diagnosis in the workup of any pedunculated vulvar mass even in young women with a lesion involving the labia minora. We reviewed the literature and summarized all reported cases. PMID:21941563

Giannella, Luca; Costantini, Matteo; Mfuta, Kabala; Cavazza, Alberto; Cerami, Lillo Bruno; Gardini, Giorgio; Boselli, Fausto

2011-01-01

66

Aggressive angiomyxoma of the vulva in a patient with systemic lupus erythematosus.  

PubMed

Aggressive angiomyxoma is a rare, slow-growing mesenchymal neoplasm with a tendency to recur. It mainly involves the pelvis, vulva, perineum, vagina, and urinary bladder in adult women of reproductive age group. We describe a 26-year-old female with large swellings of both labia majora which was histologically diagnosed as aggressive angiomyxoma. She also had systemic lupus erythematosus. The swelling was surgically removed and she had no recurrence at 1-year follow-up. Although it is a rare tumor, it must be considered as a differential diagnosis for any mass in the perineum or soft tissue of the pelvis. Long-term follow-up is necessary for early diagnosis of local recurrence. PMID:22565439

Pahwa, P; Khaitan, B K; Rao, A; Kriplani, A; Mahey, R; Subbarao, K C

2012-01-01

67

RAB-7 Antagonizes LET-23 EGFR Signaling during Vulva Development in Caenorhabditis elegans  

PubMed Central

The Rab7 GTPase regulates late endosome trafficking of the Epidermal Growth Factor Receptor (EGFR) to the lysosome for degradation. However, less is known about how Rab7 activity, functioning late in the endocytic pathway, affects EGFR signaling. Here we used Caenorhabditis elegans vulva cell fate induction, a paradigm for genetic analysis of EGFR/Receptor Tyrosine Kinase (RTK) signaling, to assess the genetic requirements for rab-7. Using a rab-7 deletion mutant, we demonstrate that rab-7 antagonizes LET-23 EGFR signaling to a similar extent, but in a distinct manner, as previously described negative regulators such as sli-1 c-Cbl. Epistasis analysis places rab-7 upstream of or in parallel to lin-3 EGF and let-23 EGFR. However, expression of gfp::rab-7 in the Vulva Presursor Cells (VPCs) is sufficient to rescue the rab-7(?) VPC induction phenotypes indicating that RAB-7 functions in the signal receiving cell. We show that components of the Endosomal Sorting Complex Required for Transport (ESCRT)-0, and -I, complexes, hgrs-1 Hrs, and vps-28, also antagonize signaling, suggesting that LET-23 EGFR likely transits through Multivesicular Bodies (MVBs) en route to the lysosome. Consistent with RAB-7 regulating LET-23 EGFR trafficking, rab-7 mutants have increased number of LET-23::GFP-positive endosomes. Our data imply that Rab7, by mediating EGFR trafficking and degradation, plays an important role in downregulation of EGFR signaling. Failure to downregulate EGFR signaling contributes to oncogenesis, and thus Rab7 could possess tumor suppressor activity in humans. PMID:22558469

Skorobogata, Olga; Rocheleau, Christian E.

2012-01-01

68

Spinal Textiloma (Gossypiboma): A Report of Three Cases Misdiagnosed as Tumour  

PubMed Central

Background: Textile products commonly used in surgery (e.g., sponges or gauze) have been known to cause complications after spinal surgery. Associated complications usually arise months or even years after the primary surgery. In case of spine surgery, these bodies are often detected during neuroradiological evaluations to investigate reported back pain; however, this complication often remains asymptomatic. Aims: The research is intended to increase awareness among both spinal surgeons and neuroradiologists of this potential complication. Study Design: Retrospective study. Methods: This study is a retrospective case series of three patients with retained surgical textile products who had been misdiagnosed with spinal tumour. The medical records of the patients were reviewed and demographic data, clinical aspects, initial diagnosis, surgical procedures, time interval between previous operation and onset of symptoms, laboratory findings, radiological findings, treatment, and outcome were analysed. Results: The three patients included two women and one man aged between 64 and 67 years. All patients had a previous surgery for lumbar disc herniation. The time from the previous surgical procedures to presentation ranged from 3 to 17 years. All patients presented with non-specific lower back pain and/or radiculopathy without clinical findings of infection. Laboratory parameters were otherwise normal. All three cases had been misdiagnosed as a spinal tumor based on magnetic resonance imaging findings. During new surgical procedures, gauze bandages, i.e., surgical textiles left during a previous operation, were found. Conclusion: Textiloma is an important and rarely mentioned potential neurosurgical complication that may remain asymptomatic for years. They are more common in obese patients, after emergency surgery, and with unplanned changes in surgical procedure such as bleeding and unintended neurosurgical complications. Neuroradiological findings are variable and non-specific; thus, patients could be misdiagnosed with a spinal tumor or abscess. Likewise, in patients with a history of spinal surgery, spinal abscesses, haematomas, hypertrophic scars, fibrosarcomas, rhabdomyosarcomas, and schwannomas should definitely be considered in the differential diagnosis and considered when planning diagnostic procedures. Appropriate antibiotic therapy is recommended when a suppurative complication is present or suspected. Textiloma is a medico-legal complication that can be prevented by the education of surgical staff, the counting method (preoperatively, at closure, and at the end), and use of products with radiopaque barcodes. PMID:25207152

?ahin, Soner; Atabey, Cem; ?im?ek, Mehmet; Naderi, Sait

2013-01-01

69

Pseudodyssynergia (Contraction of the External Sphincter During Voiding) Misdiagnosed as Chronic Nonbacterial Prostatitis and the Role of Biofeedback as a Therapeutic Option  

Microsoft Academic Search

PurposeChronic lower urinary tract symptoms in young men are often attributed to misdiagnosed chronic nonbacterial prostatitis. We analyzed contraction of the external urinary sphincter during voiding (pseudodyssynergia) as an etiology of voiding dysfunction in men with misdiagnosed chronic prostatitis.

Steven A. Kaplan; Richard P. Santarosa; Patricia Meade D'Alisera; Brenda J. Fay; Edward F. Ikeguchi; James Hendricks; Lonnie Klein; Alexis E. Te

1997-01-01

70

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

PubMed Central

Introduction Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF) hypovolemia. Objective To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture. Observation A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI) showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence. Conclusion Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures. PMID:24470768

Louhab, Nissrine; Adali, Nawal; Laghmari, Mehdi; Hymer, Wafae El; Ben Ali, Said Ait; Kissani, Najib

2014-01-01

71

A Case of Adult Onset Still's Disease Misdiagnosed as Septic Arthritis  

PubMed Central

We present a case of adult onset Still's disease (AOSD) that was misdiagnosed as septic arthritis of the shoulder and knee. A forty-nine-year-old woman was admitted for pain in the left knee. The patient's medical history showed that she had undergone arthroscopic irrigation twice and an open debridement under the diagnosis of septic shoulder at another hospital. The laboratory and joint fluid analysis findings led us to suspect septic knee. Arthroscopic irrigation and antibiotics treatment were performed. At five weeks after discharge, she presented with pain in the same joint, fever, and rash. The symptoms were consistent with Yamaguchi's criteria for AOSD. We started corticosteroid therapy, and clinical remission was achieved. In conclusion, we suggest that AOSD should be considered as a diagnosis of exclusion to avoid misdiagnosis with septic arthritis. PMID:22570830

Song, Sang Jun; Noh, Jung Ho; Seo, Geon Wook; Nam, Dong Cheol

2011-01-01

72

Cutaneous fistula of liver echinococcal cyst previously misdiagnosed as fistulizated rib osteomyelitis  

PubMed Central

External fistulization or subcutaneous rupture of liver echinococcal cyst (EC) is found occasionally with total of 15 cases reported in the literature. We report a case of 60-year-old female previously misdiagnosed as fistulizated osteomyelitis of the 11th rib. At computed tomography scan, non-vital EC was noted in the third liver segment. Under suspicion of external fistulization of perforated EC the patient underwent one-stage operation-pericystectomy and complete fistula excision. A retrospective analysis of the reported cases in the literature was performed with special references to classifying this rare entity. The main purpose of this report is to highlight the possibility of such a diagnosis when cutaneous fistula occurs in a same anatomic area with hydatid EC, even that cyst is proven to be calcified. We emphasize the role of a swift and radical surgical procedure including complete fistula excision to prevent secondary dissemination and post-operative complications. PMID:24471005

Kjossev, Kirien T; Teodosiev, Ivan L

2013-01-01

73

Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers  

PubMed Central

A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC. PMID:24575003

Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

74

The Caenorhabditis elegans CDT-2 ubiquitin ligase is required for attenuation of EGFR signalling in vulva precursor cells  

E-print Network

from the same mothers. Therefore the analysed animals were at roughly the same age in absolute time. vit-2::gfp assay Briefly, the vit-2::gfp assay was performed as described [20], and RNAi perform as indicated above. Young adults were analysed... exces- sive LET-23 signalling during vulva development. Indeed, experiments using hydroxyurea to arrest the VPC cell cycle have shown that egl-17 expression remains restricted to P6.p [37]. Therefore, a replication block after first division...

Poulin, Gino B; Ahringer, Julie

2010-10-26

75

Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review  

PubMed Central

The aim of this study was to improve the level of diagnosis and differential diagnosis of lymphomatoid papulosis (LyP). Two cases of type B LyP were identified and the literature was reviewed to summarize the clinical outcomes and pathology of LyP and its treatment. The two patients exhibited symptoms with papulonodular lesions, the centers of which gradually underwent ulceration and necrosis. CD30, a helper T-cell marker specifically expressed in tumor cells was analyzed by immunohistochemical staining and the result showed that CD30-negative or only scattered CD30-positive cells were present. Therefore, a diagnosis of type B LyP was made. A fairly good curative effect was achieved following treatment with retinoic acid, glucocorticoids and immunomodulatory drugs. LyP is a type of low-level malignant lymphoma and is easily misdiagnosed as pityriasis lichenoides et varioliformis acuta and other diseases. In order to avoid under diagnosis and misdiagnosis, doctors should evaluate suspected patients by histopathological and immunohistochemical examination. PMID:25371758

ZHENG, YAN; JIA, JINJING; TIAN, QIONG; DONG, XINYU; WANG, XIN; YING, ZHAOXIA; XIAO, SHENGXIANG; LI, WENSHENG

2014-01-01

76

Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses  

PubMed Central

Background Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic. Findings The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained. Conclusions As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater. PMID:24020375

2013-01-01

77

Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis  

PubMed Central

Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery. PMID:25386373

Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

2014-01-01

78

"Light cupula" involving all three semicircular canals: A frequently misdiagnosed disorder.  

PubMed

Though benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder causing positional vertigo, patients with typical positional vertigo in which the findings of positional nystagmus do not meet the diagnostic criteria for BPPV are often encountered in the clinic. Recently a concept of the light cupula was introduced, which accounts for some of positional vertigo. Under a normal condition in which the specific gravity of the cupula is same as that of the surrounding endolymph, semicircular canals (SCCs) are not influenced by the gravity. The light cupula, which indicates cupula with lower specific gravity than the surrounding endolymph, is characterized by persistent geotropic direction-changing positional nystagmus (DCPN) without latency on the supine head-roll test and the presence of a null plane. Unless the duration and pattern of positional nystagmus are carefully examined, the light cupula can be misdiagnosed as other types of BPPV. We present a patient with light cupula on the right side who reported recurrent episodes of positional vertigo and had been diagnosed as BPPV with multiple canal involvement (posterior and lateral SCCs) on the opposite side. In this study, we present the mechanism of typical positional nystagmus patterns in patients with light cupula involving all of the unilateral SCCs, and discuss the possible causes of misdiagnosis of the light cupula. PMID:25249441

Kim, Chang-Hee; Shin, Jung Eun; Shin, Dong Hyuk; Kim, Yong Won; Ban, Jae Ho

2014-11-01

79

Case report of narcolepsy in a six-year-old child initially misdiagnosed as atypical epilepsy  

PubMed Central

Summary This report describes a case of first-onset narcolepsy in a six-year-old female that was misdiagnosed as atypical epilepsy and other diagnoses at eight different hospitals over a period of 10 months before the correct diagnosis was made. The diagnosis of narcolepsy is more difficult in children because very few of them experience all four cardinal symptoms of narcolepsy – paroxysmal sleep, cataplexy, hypnagogic hallucination, and sleep paralysis – and they often have a more prolonged onset and diverse symptoms. To decrease the time lag between initial presentation and accurate diagnosis, we recommend that in all cases in which children report excessive sleep of unknown etiology – regardless of the associated symptoms – that sleep monitoring and sleep latency tests be conducted to rule out the possibility of narcolepsy. The case highlights the wide variety of presentations of uncommon psychiatric conditions, particularly in children, and the need for clinicians to be aware of the atypical presentations of these conditions when collecting medical histories. PMID:25317010

ZHOU, Jinquan; ZHANG, Xi; DONG, Zaiwen

2014-01-01

80

Unusual mucoepidermoid carcinoma of the liver misdiagnosed as squamous cell carcinoma by intraoperative histological examination  

PubMed Central

As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic mucoepidermoid carcinoma misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive jaundice, epigastric discomfort, and weight loss with slightly increased carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod carcinoma of liver by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060 PMID:24475740

2014-01-01

81

Oncogenic viruses associated with vulva cancer in HIV-1 patients in Botswana  

PubMed Central

Background Oncoviruses such as HPV, KSHV, and EBV have been reported in patients with HIV infection and AIDS. How oncovirus-associated cancers rise in AIDS patients has not been fully established. The purpose of our study was to identify the viral agents in vulvar cancer and to assess their contribution to pathogenesis. Method We retrospectively identified a total of 13 vulva tissue samples from HIV-1 positive and 9 vulvar samples from HIV-1 negative patients from the Botswana National Health Laboratory in Gaborone, Botswana, a Southern African country with a high incidence of HIV. We utilized PCR and IHC to identify HPV, EBV, KSHV, and JC virus in FFPE preserved tissue samples. Results Using the GP5+/GP6+ primer set we detected several HPV types in tissue samples. EBV was detected in all of the positive cases (100%) and in most of the negative cases (89%). KSHV was detected in 39% of the HIV-1 positive samples and in 11% of the negative samples, and no JC virus was detected in any of the samples. Using IHC we demonstrated that LANA was expressed in 61% of the positive samples and in 44% of the negative samples. The ubiquitous EBV was more consistently expressed in negative cases (100%) than in positive cases (69%). Interestingly, the HPV-16 E6 transcript was detected in 56% of the negative samples compared to 31% of the positive samples. However, the cell cycle protein P21 used as a surrogate marker for HPV was detected in 77% of the positive samples and in 44% of the negative samples, while VEGF signals were similar in both positive (92%) and negative samples (89%). Conclusion Our study, suggests that in Botswana, vulvar squamous cell carcinoma (VSCC) is associated with oncogenic viruses present in the niche but the contribution and progression may be regulated by HPV and other immunosuppressive infections that include HIV-1. PMID:25225572

2014-01-01

82

Premalignant lesions of the lower female genital tract: cervix, vagina and vulva.  

PubMed

Premalignant lesions of the lower female genital tract encompassing the cervix, vagina and vulva are variably common and many, but by no means all, are related to infection by human papillomavirus (HPV). In this review, pathological aspects of the various premalignant lesions are discussed, mainly concentrating on new developments. The value of ancillary studies, mainly immunohistochemical, is discussed at the appropriate points. In the cervix, the terminology and morphological features of premalignant glandular lesions is covered, as is the distinction between adenocarcinoma in situ (AIS) and early invasive adenocarcinoma, which may be very problematic. A spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation is emerging with lobular endocervical glandular hyperplasia (LEGH), including so-called atypical LEGH, representing a possible precursor of non HPV-related cervical adenocarcinomas exhibiting gastric differentiation; these include the cytologically bland adenoma malignum and the morphologically malignant gastric type adenocarcinoma. Stratified mucin producing intraepithelial lesion (SMILE) is a premalignant cervical lesion with morphological overlap between cervical intraepithelial neoplasia (CIN) and AIS and which is variably regarded as a form of reserve cell dysplasia or stratified AIS. It is now firmly established that there are two distinct types of vulval intraepithelial neoplasia (VIN) with a different pathogenesis, molecular events, morphological features and risk of progression to squamous carcinoma. These comprise a more common HPV-related usual type VIN (also referred to as classic, undifferentiated, basaloid, warty, Bowenoid type) and a more uncommon differentiated (simplex) type which is non-HPV related and which is sometimes associated with lichen sclerosus. The former has a relatively low risk of progression to HPV-related vulval squamous carcinoma and the latter a high risk of progression to non-HPV related vulval squamous carcinoma. Various aspects of vulval Paget's disease are also discussed. PMID:23442737

McCluggage, W Glenn

2013-04-01

83

Localized amyloidosis of the vulva with and without vulvar intraepithelial neoplasia: report of a series.  

PubMed

Localized primary cutaneous amyloidosis is uncommon in Europe and North America and is infrequently reported in the English literature. The constituents of such deposits have not been previously examined; this series characterizes amyloid deposits in localized vulvar amyloidosis and their association with vulvar intraepithelial neoplasia. All biopsies and excisions of vulva over 18 months were reviewed. Cases with suspected amyloidosis were retrieved after institutional review board approval. Twenty cases mimicking amyloidosis were selected as controls. All study and control cases were stained with Congo red. Four Congo red-positive study cases were studied by liquid chromatography-tandem mass spectrometry. Of 27 Congo red-positive study cases, 25 were then examined by immunohistochemical stains with antibodies to cytokeratin 5 (CK5) and cytokeratin 14 (CK14). Of 149 cases reviewed, 26 localized and 1 systemic vulvar amyloidosis were identified. Liquid chromatography-tandem mass spectrometry analysis of the deposits revealed unique peptide profile consistent with CK5 and CK14. Immunohistochemical staining with antibodies to CK5 and CK14 also detected these components in the deposits. The vulvar deposit of systemic amyloidosis consisted of amyloid light chain (?)-type amyloid deposit. All control cases were negative for Congo red. Keratin-associated amyloid materials (CK5 and CK14) were found to be unique in localized vulvar amyloidosis. Leakage of keratins from the basal layer of the epithelium into the superficial dermis may have been the possible source of the deposits. It appears to be associated with both high-grade and low-grade vulvar intraepithelial neoplasias and, rarely, lichen sclerosus, seborrheic keratosis, and benign vulvar skin. PMID:25149547

Quddus, M Ruhul; Sung, C James; Simon, Rochelle A; Lawrence, W Dwayne

2014-10-01

84

Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers  

USGS Publications Warehouse

Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki S.; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore, Jr.; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

2014-01-01

85

Nonlesions, Misdiagnoses, Missed Diagnoses, and Other Interpretive Challenges in Fish Histopathology Studies: A Guide for Investigators, Authors, Reviewers, and Readers.  

PubMed

Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data. PMID:25112278

Wolf, Jeffrey C; Baumgartner, Wes A; Blazer, Vicki S; Camus, Alvin C; Engelhardt, Jeffery A; Fournie, John W; Frasca, Salvatore; Groman, David B; Kent, Michael L; Khoo, Lester H; Law, Jerry M; Lombardini, Eric D; Ruehl-Fehlert, Christine; Segner, Helmut E; Smith, Stephen A; Spitsbergen, Jan M; Weber, Klaus; Wolfe, Marilyn J

2014-08-11

86

Clear cell sarcoma of the kidney misdiagnosed as mesoblastic nephroma: a case report and review of the literature.  

PubMed

Clear cell sarcoma of the kidney (CCSK) is a rare renal neoplasm of paediatrics, making up about 3% of all renal tumours in paediatrics, with a high tendency for developing bone metastasis. A seven year-old boy was referred to our clinic with two firm, large masses over the manubrium of the sternum and right frontal area, which pathologically were confirmed as a metastatic CCSK. The patient had a history of a renal mass three years earlier, for which radical nephrectomy had been performed, and histopathologic diagnosis was compatible with mesoblastic nephroma. Thus, no further investigation and therapy had been applied for the patient. CCSK is a rare but malignant and aggressive paediatric renal tumour, with a high tendency for developing distant bone metastases, leading to its poor prognosis. CCSK could be misdiagnosed as several other renal tumours such as mesoblastic nephroma, and thus CCSK should be taken carefully into consideration in the diagnosis of renal tumours. PMID:23634181

Alavi, Samin; Khoddami, Maliheh; Yazdi, Mohammad Kaji; Dehghanian, Paria; Esteghamati, Sadaf

2013-01-01

87

Clear cell sarcoma of the kidney misdiagnosed as mesoblastic nephroma: a case report and review of the literature  

PubMed Central

Clear cell sarcoma of the kidney (CCSK) is a rare renal neoplasm of paediatrics, making up about 3% of all renal tumours in paediatrics, with a high tendency for developing bone metastasis. A seven year-old boy was referred to our clinic with two firm, large masses over the manubrium of the sternum and right frontal area, which pathologically were confirmed as a metastatic CCSK. The patient had a history of a renal mass three years earlier, for which radical nephrectomy had been performed, and histopathologic diagnosis was compatible with mesoblastic nephroma. Thus, no further investigation and therapy had been applied for the patient. CCSK is a rare but malignant and aggressive paediatric renal tumour, with a high tendency for developing distant bone metastases, leading to its poor prognosis. CCSK could be misdiagnosed as several other renal tumours such as mesoblastic nephroma, and thus CCSK should be taken carefully into consideration in the diagnosis of renal tumours. PMID:23634181

Alavi, Samin; Khoddami, Maliheh; Yazdi, Mohammad Kaji; Dehghanian, Paria; Esteghamati, Sadaf

2013-01-01

88

Posterior microphthalmos and papillomacular fold-associated cystic changes misdiagnosed as cystoid macular edema following cataract extraction  

PubMed Central

Purpose Novel spectral-domain optical coherence tomography (SD-OCT) findings in posterior microphthalmos (PM) include cystoid changes in the papillomacular fold (PMF). These changes may be misdiagnosed as cystoid macular edema (CME) and may trigger unnecessary treatment including intravitreal injections. We report a case that underscores this scenario aiming to increase awareness of this entity among ophthalmologists. Method A case report. Results A 25-year-old male presented with a history of clear lens extraction in both eyes as a refractive procedure. Postoperatively, he was diagnosed with CME and received five intravitreal bevacizumab injections in each eye as well as oral diamox for persistent cystic spaces noted on OCT. He was referred to our institution with the diagnosis of non-responding CME. A complete ophthalmic evaluation, including ultrasonography and SD-OCT, confirmed the diagnosis of PM and PMF with cystic cavities in the PMF. A fluorescein angiogram disclosed absence of macular leakage or optic nerve head staining indicating that the cystic cavities seen on SD-OCT are not due to postoperative CME but are rather the intrinsic cystic changes commonly seen in eyes with PM and a PMF. These cystic cavities were incorrectly thought to represent postoperative CME, which triggered the unnecessary treatment and lack of response. Conclusion Cystic-like cavities are a component of the PMF in PM eyes and may be misdiagnosed as CME, especially in a postoperative setting. This case underscores the importance of understanding the intrinsic features of the PMF in eyes with PM and may help increase awareness among ophthalmologists of such a potentially confusing scenario. PMID:25609908

Albar, Ahmad A; Nowilaty, Sawsan R; Ghazi, Nicola G

2015-01-01

89

Defining the concept of locally advanced squamous cell carcinoma of the vulva: a new perspective based on standardization of criteria and current evidence  

PubMed Central

The phrase "locally advanced carcinoma of the vulva" has often been mentioned in the literature, though not accurately defined, or even leading to the interpretation overlapping. Grounded on cervical cancer experience, we are able to state that designing a tailored primary strategy based on clinically measurable adverse prognostic factors represents the cornerstone of therapy. This fact urged us to rethink about the real usefulness of the concept of locally advanced squamous cell carcinoma of the vulva. We will refer to this concept as a clinical entity emerging from a rigorous workup which is a valuable guiding tool in the context of a thorough debate about the best primary treatment approach to be used. Furthermore, bulky tumors of the vulva have been associated with a worse prognosis on several occasions. Some authors have questioned the fact that tumor size has not been considered in the staging system. Finally, a standardized definition will help us compare the results obtained, which is extremely necessary given the worldwide low prevalence of this disease. PMID:25142626

Soderini, Alejandro H.; Cuneo, Nicasio A.

2014-01-01

90

Langerhans cells in lichen sclerosus of the vulva and lichen sclerosus evolving in vulvar squamous cell carcinoma.  

PubMed

Vulvar lichen sclerosus (LS) represents a benign chronic inflammatory skin lesion that carries a risk for development of vulvar squamous cell carcinoma (SCC). We aimed at determining whether premalignant changes in vulvar LS, a multifactorial disease, presenting a welter of evidence implicating the immune system in its pathogenesis, could be identified by analysing the Langerhans' cells (LCs), the primary cell responsible for antigen recognition and presentation. The relationship existing between inflammation and cancer due to chronic infection, and demonstrated in many solid tumors, led us to study LCs in eight cases of vulvar LS, which showed an evolution to carcinoma of the vulva and in ten cases of unchanged vulvar LS in matched patients by immunohistochemistry for antibodies CD1a and S100. We did not find a statistically significantly different number of LCs counted either in S100 stained specimens, nor in CD1a stained specimens of LS epithelium in unchanged or evolving cases. The data emerging in our study do not support the hypothesis that the variation in the number of LCs may be related to the development of SCC in late stage LS cases. PMID:19130403

Raspollini, Maria Rosaria; Baroni, Gianna; Taddei, Gian Luigi

2009-03-01

91

A case of lumbar sciatica in a patient with spondylolysis and spondylolysthesis and underlying misdiagnosed brucellar discitis.  

PubMed

We report the case of a patient affected by vertebral pain refractory to conventional analgesic therapy with a diagnosis of spondylolysthesis and also the affects of a misdiagnosed brucellar spondylodiscitis. The absence of a positive response to conventional analgesics, a suggestive medical history (epidemiologic data still show a high incidence of Brucella infections for the Province of Catania), radiological findings and microbiological tests led to the correct diagnosis of algic syndrome in a patient affected by brucellar spondylodiscitis with the concomitant presence of retroperitoneal muscular abscess, and a previously diagnosed spondylolysthesis. All symptoms improved after correct antibrucellar antibiotic therapy and surgical drainage of the retroperitoneal abscess. Vertebral pain is a relatively frequent symptom observed in Pain Medicine Services; in a zone in which Brucella infections may be considered endemic, neurobrucellosis must be considered highly probable in the differential diagnosis of several clinical pictures, including vertebral pain that could result from vertebral localization of Brucella infection. The role of the Pain Medicine Specialist is not only to treat the symptoms, but also to research and confirm the etiopathogenetic mechanisms before starting a correct treatment. PMID:17529921

Guglielmino, A; Sorbello, M; Murabito, P; Naimo, J; Palumbo, A; Lo Giudice, E; Giuffrida, S; Fazzio, S; Parisi, G; Mangiameli, S

2007-05-01

92

Caenorhabditis elegans histone deacetylase hda-1 is required for morphogenesis of the vulva and LIN-12/Notch-mediated specification of uterine cell fates.  

PubMed

Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1, a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-seam cell). We characterized the vulval defects by using cell fate-specific markers and found that hda-1 is necessary for the specification of all seven vulval cell types. The analysis of the vulval-uterine connection defect revealed that hda-1 is required for the differentiation of the gonadal anchor cell (AC), which in turn induces ventral uterine granddaughters to adopt ? fates, leading to the formation of the uterine-seam cell. Consistent with these results, hda-1 is expressed in the vulva and AC. A search for hda-1 target genes revealed that fos-1 (fos proto-oncogene family) acts downstream of hda-1 in vulval cells, whereas egl-43 (evi1 proto-oncogene family) and nhr-67 (tailless homolog, NHR family) mediate hda-1 function in the AC. Furthermore, we showed that AC expression of hda-1 plays a crucial role in the regulation of the lin-12/Notch ligand lag-2 to specify ? cell fates. These results demonstrate the pivotal role of hda-1 in the formation of the vulva and the vulval-uterine connection. Given that hda-1 homologs are conserved across the phyla, our findings are likely to provide a better understanding of HDAC1 function in development and disease. PMID:23797102

Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P

2013-08-01

93

Role of paclitaxel and cisplatin as the neoadjuvant treatment for locally advanced squamous cell carcinoma of the vulva  

PubMed Central

Objective The therapeutic outcomes of patients with advanced vulvar cancer are poor. Multi-modality treatments including concurrent chemoradiation or different regimens of neoadjuvant chemotherapy (NACT), and surgery have been explored to reduce the extent of surgery and morbidity. The present single-institution trial aimed to evaluate the efficacy and toxicity of paclitaxel and cisplatin in locally advanced vulvar cancer. Methods From 2002 to 2009, 10 patients with stage III-IV locally advanced squamous cell carcinoma of the vulva were prospectively treated with 3 courses of paclitaxel-ifosfamide-cisplatin or paclitaxel-cisplatin. Nine of them subsequently underwent radical local excision or radical partial vulvectomy and bilateral inguino-femoral lymphadenectomy. Results The clinical response rate of all enrolled patients was 80%, whereas the pathological responses included 1 case with complete remission, 2 with persistent carcinoma in situ, and 6 invasive cancer cases with tumor shrinkage of more than 50%. Four patients had positive nodes. Forty percent of patients experienced grade 3-4 bone marrow toxicity, which was successfully managed with granulocyte-colony stimulating factor, even in cases of elderly patients. Median progression-free survival after surgery was 14 months (range, 5 to 44 months). Six of the 7 recurrent cases were local, and 3 of them were treated with salvage surgery while the other 3 received radiation with or without chemotherapy. After a median follow-up period of 40 months (range, 5 to 112 months), 55.5% of patients remained alive with no evidence of disease, including 2 long-term survivors after recurrence at 5 and 9 years. Conclusion Based on the high response rate and manageable toxicity, NACT with paclitaxel and cisplatin with or without ifosfamide followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer. PMID:24459577

Zanaboni, Flavia; Martinelli, Fabio; Scasso, Santiago; Laufer, Joel; Ditto, Antonino

2014-01-01

94

Different DNA damage and cell cycle checkpoint control in low- and high-risk human papillomavirus infections of the vulva.  

PubMed

Human papillomavirus (HPV) infections may result in benign hyperplasia, caused by low-risk HPV types, or (pre)malignant lesions caused by high-risk HPV types. The molecular basis of this difference in malignant potential is not completely understood. Here, we performed gene profiling of different HPV infected vulvar tissues (condylomata acuminata (n = 5), usual type vulvar intraepithelial neoplasia (uVIN) (n = 9)) and control samples (n = 14) using Affymetrix Human U133A plus 2 GeneChips. Data were analyzed using OmniViz®, Partek® and Ingenuity® Software. Results were validated by real-time RT-PCR and immunostaining. Although similarities were observed between gene expression profiles of low- and high-risk HPV infected tissues (e.g., absence of estrogen receptor in condylomata and uVIN), high-risk HPV infected tissues showed more proliferation and displayed more DNA damage than tissues infected with low-risk HPV. These observations were confirmed by differential regulation of cell cycle checkpoints and by increased expression of DNA damage-biomarkers p53 and ?H2AX. Furthermore, FANCA, FANCD2, BRCA1 and RAD51, key players in the DNA damage response, were significantly upregulated (p < 0.05). In addition, we compared our results with publicly available gene expression profiles of various other HPV-induced cancers (vulva, cervix and head-and-neck). This showed p16(INK4a) was the most significant marker to detect a high-risk HPV infection, but no other markers could be found. In conclusion, this study provides insight into the molecular basis of low- and high-risk HPV infections and indicates two main pathways (cell cycle and DNA damage response) that are much stronger affected by high-risk HPV as compared to low-risk HPV. PMID:21815142

Santegoets, Lindy A M; van Baars, Romy; Terlou, Annelinde; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; van der Meijden, Willem I; Helmerhorst, Theo J M; Blok, Leen J

2012-06-15

95

Aggressive angiomyxoma of the vulva: intra-operative pathological diagnosis is useful in deciding the scope of surgery and reducing recurrence.  

PubMed

Aggressive angiomyxoma (AA) is a rare, slow-growing myxoid neoplasm of the pelvi-perineum. Because of its rarity, it is often initially misdiagnosed, frequently as a gynaecological malignancy. Surgical resection is the main treatment modality of AA, but, local recurrence rates are high. In order to reduce recurrence, the scope of surgical resection should be as broad as possible. Intra-operative pathological diagnosis is useful in deciding the scope of surgery, and wide excision may reduce recurrence. PMID:22442917

Wang, Q; Zhao, M; Lin, X; Zhong, W; Gao, Y

2012-01-01

96

Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study  

PubMed Central

Purpose To determine the safety of sentinel lymph node biopsy as a replacement for inguinal femoral lymphadenectomy in selected women with vulvar cancer. Patients and Methods Eligible women had squamous cell carcinoma, at least 1-mm invasion, and tumor size ? 2 cm and ? 6 cm. The primary tumor was limited to the vulva, and there were no groin lymph nodes that were clinically suggestive of cancer. All women underwent intraoperative lymphatic mapping, sentinel lymph node biopsy, and inguinal femoral lymphadenectomy. Histologic ultra staging of the sentinel lymph node was prescribed. Results In all, 452 women underwent the planned procedures, and 418 had at least one sentinel lymph node identified. There were 132 node-positive women, including 11 (8.3%) with false-negative nodes. Twenty-three percent of the true-positive patients were detected by immunohistochemical analysis of the sentinel lymph node. The sensitivity was 91.7% (90% lower confidence bound, 86.7%) and the false-negative predictive value (1-negative predictive value) was 3.7% (90% upper confidence bound, 6.1%). In women with tumor less than 4 cm, the false-negative predictive value was 2.0% (90% upper confidence bound, 4.5%). Conclusion Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected women with squamous cell carcinoma of the vulva. PMID:22753905

Levenback, Charles F.; Ali, Shamshad; Coleman, Robert L.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

2012-01-01

97

Aggressive angiomyxoma of vulva.  

PubMed

A lady of 44 years presented with progressively growing non-tender mass in the right labia majora over a period of one year. Ultrasound showed large perineal mass with predominantly echogenic low resistance type of arterial blood flow at different places on ultrasound. CT scan showed well-defined margins with attenuation less than that of muscle. MRI showed high signal intensity related to loose myxoid matrix and high water content of angiomyxoma. PMID:23823959

Bakhtiar, Umber Jalil; Awan, Azra Saeed

2013-07-01

98

Disorders of the Vulva  

MedlinePLUS

... infection) and sexually transmitted diseases , such as genital herpes , can cause vulvar signs and symptoms (see the ... A female hormone produced in the ovaries. Genital Herpes: A sexually transmitted disease caused by a virus ...

99

Cancer of the Vulva  

MedlinePLUS

... includes: Inner and outer lips of the vagina. Clitoris (sensitive tissue between the lips). Opening of the ... Less often, cancer affects the inner vaginal lips, clitoris, or vaginal glands. Vulvar cancer usually forms slowly ...

100

Lymphoepithelioma-like carcinoma of the vulva, an underrecognized entity? Case report with a single inguinal micrometastasis detected by sentinel node technique  

PubMed Central

This report describes an unusual EBV-negative lymphoepithelioma-like carcinoma of the vulva in a 73-year-old patient. The lesion was localised at the right minor labium and was resected by partial vulvectomy. A synchronous sentinel lymph node biopsy revealed a single micrometastasis in the right inguinal region, which prompted local radiotherapy. Follow-up nine months later showed only slight vulvar atrophy, without signs of local recurrence or distant metastases. Although lymphoepithelioma-like carcinomas of the skin and the female genital tract are presumed to have a better prognosis than their counterparts in the upper aerodigestive tract, possibly due to earlier detection and therapy, this case documents their potential for early metastasis. PMID:21219641

2011-01-01

101

H3K9me2/3 Binding of the MBT Domain Protein LIN-61 Is Essential for Caenorhabditis elegans Vulva Development  

PubMed Central

MBT domain proteins are involved in developmental processes and tumorigenesis. In vitro binding and mutagenesis studies have shown that individual MBT domains within clustered MBT repeat regions bind mono- and dimethylated histone lysine residues with little to no sequence specificity but discriminate against the tri- and unmethylated states. However, the exact function of promiscuous histone methyl-lysine binding in the biology of MBT domain proteins has not been elucidated. Here, we show that the Caenorhabditis elegans four MBT domain protein LIN-61, in contrast to other MBT repeat factors, specifically interacts with histone H3 when methylated on lysine 9, displaying a strong preference for di- and trimethylated states (H3K9me2/3). Although the fourth MBT repeat is implicated in this interaction, H3K9me2/3 binding minimally requires MBT repeats two to four. Further, mutagenesis of residues conserved with other methyl-lysine binding MBT regions in the fourth MBT repeat does not abolish interaction, implicating a distinct binding mode. In vivo, H3K9me2/3 interaction of LIN-61 is required for C. elegans vulva development within the synMuvB pathway. Mutant LIN-61 proteins deficient in H3K9me2/3 binding fail to rescue lin-61 synMuvB function. Also, previously identified point mutant synMuvB alleles are deficient in H3K9me2/3 interaction although these target residues that are outside of the fourth MBT repeat. Interestingly, lin-61 genetically interacts with two other synMuvB genes, hpl-2, an HP1 homologous H3K9me2/3 binding factor, and met-2, a SETDB1 homologous H3K9 methyl transferase (H3K9MT), in determining C. elegans vulva development and fertility. Besides identifying the first sequence specific and di-/trimethylation binding MBT domain protein, our studies imply complex multi-domain regulation of ligand interaction of MBT domains. Our results also introduce a mechanistic link between LIN-61 function and biology, and they establish interplay of the H3K9me2/3 binding proteins, LIN-61 and HPL-2, as well as the H3K9MT MET-2 in distinct developmental pathways. PMID:21437264

Koester-Eiserfunke, Nora; Fischle, Wolfgang

2011-01-01

102

Human Papillomavirus Genotyping and E6/E7 mRNA Expression in Greek Women with Intraepithelial Neoplasia and Squamous Cell Carcinoma of the Vagina and Vulva  

PubMed Central

A large proportion of vaginal and vulvar squamous cell carcinomas (SCCs) and intraepithelial neoplasias (VAIN and VIN) are associated with HPV infection, mainly type 16. The purpose of this study was to identify HPV genotypes, as well as E6/E7 mRNA expression of high-risk HPVs (16, 18, 31, 33, and 45) in 56 histology samples of VAIN, VIN, vaginal, and vulvar SCCs. HPV was identified in 56% of VAIN and 50% of vaginal SCCs, 71.4% of VIN and 50% of vulvar SCCs. E6/E7 mRNA expression was found in one-third of VAIN and in all vaginal SCCs, 42.9% of VIN and 83.3% of vulvar SCCs. Our data indicated that HPV 16 was the commonest genotype identified in VAIN and VIN and the only genotype found in SCCs of the vagina and vulva. These findings may suggest, in accordance with other studies, that mRNA assay might be useful in triaging lesions with increased risk of progression to cancer. PMID:22187556

Tsimplaki, Elpida; Argyri, Elena; Michala, Lina; Kouvousi, Maria; Apostolaki, Aikaterini; Magiakos, George; Papassideri, Issidora; Panotopoulou, Efstathia

2012-01-01

103

Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature  

PubMed Central

Purpose To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). Case presentation In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease. After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. Conclusion GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate. PMID:24758544

2014-01-01

104

Basal cell carcinomas of the vulva: high-risk human papillomavirus DNA detection, p16 and BerEP4 expression.  

PubMed

Basal cell carcinoma (BCC) of the vulva is rare and may be confused with the much more commonly encountered high-risk human papillomavirus (HPV)-related basaloid squamous cell carcinoma (SCC). The HPV status of BCCs is not well established. This study assesses the utility of p16 and BerEP4 expression patterns and high-risk HPV detection for distinction of these tumors. Thirteen cases of vulvar BCC were analyzed by immunohistochemistry for p16 and BerEP4 expression. HPV status was assessed by in situ hybridization (ISH) with a high-risk HPV wide-spectrum probe and HPV 16 and 18 type-specific probes. All tumors (13/13) demonstrated patchy p16 positivity, with <50% of tumor cells expressing p16 in all cases. None demonstrated the diffuse p16 expression characteristic of high-risk HPV-associated lesions. No high-risk HPV was detected by ISH (0/13). Eleven of 13 (85%) vulvar BCCs showed diffuse, intense expression of BerEP4. The 2 BerEP4-negative cases were notably squamatized. The lack of diffuse p16 expression and failure to detect high-risk HPV by ISH in vulvar BCCs indicate that these tumors are unrelated to high-risk HPV. Thus, these ancillary techniques, particularly p16 immunohistochemistry, are useful for distinguishing vulvar BCCs from basaloid forms of high-risk HPV-related vulvar SCC. BerEP4 expression can help in distinction of these tumors except in cases of BCC with extensive squamatization. Distinction of vulvar BCC from basaloid SCC is important because of differences in extent of surgical treatment for these entities. PMID:24625418

Elwood, Hillary; Kim, Jinah; Yemelyanova, Anna; Ronnett, Brigitte M; Taube, Janis M

2014-04-01

105

Löfgren's syndrome misdiagnosed as cellulitis.  

PubMed

Löfgren's syndrome is an acute-onset presentation of sarcoidosis that can be easily missed in an ED setting. A case is reported of Löfgren's syndrome presenting as erythema nodosum with bilateral ankle oedema. Although rare, this diagnosis should be considered when examining a patient with erythema nodosum and articular symptoms. PMID:21668726

Cheng, Daryl Ray; Maini, Amit

2011-06-01

106

Aggressive angiomyxoma of the vulva.  

PubMed

Aggressive angiomyxoma is a rare, benign neoplasm occurring in 3(rd) to 5(th) decade of life that can be mistaken both clinically and on microscopy for several other conditions, it should be included as a differential diagnosis for any vaginal mass. These lesions have a predilection for female pelvic soft tissues, slow in growth, and are characterized histologically by a predominantly myxoid stroma and an abundance of thin and thick walled vascular channels. This is a deep soft tissue tumor, which as the name suggests, may have a locally aggressive course. Most tumors occur in women and are large, usually greater than 10 cm, slowly growing, and painless. Standard of care treatment for angiomyxoma has been surgery. Some authors believe that it is the only possible treatment, but surgery is often radical and can be mutilating, with massive blood loss. PMID:22923982

Barmon, Debabrata; Kataki, Amal Chandra; Sharma, J D; Bordoloi, Judy

2012-01-01

107

Erosive diseases of the vulva.  

PubMed

Vesicobullous and inflammatory diseases produce vulvar erosions that may exhibit nonspecific morphology and represent a diagnostic challenge. An approach to arriving at the correct diagnosis is presented. Most common etiologies are reviewed. PMID:20883917

Pipkin, Clare

2010-10-01

108

Feminization and reduction of testicular weight in mouse sparganosis  

PubMed Central

After infection of male mice with the plerocercoids (spargana) of Spirometra mansoni, serum levels of estrogen and testicular weight were analyzed by enzyme-linked immunosorbent assay (ELISA) and weighing machine, respectively. The serum level of estrogen increased progressively in infected mice compared with normal controls, whereas the testicular weight of infected mice decreased significantly (P < 0.05). These results suggest that certain substances from spargana change the steroid hormone metabolisms in the host by unknown pathways, and chronic infection may contribute to change of the function of steroid hormone target organ, i.e., testis, in male mice. PMID:16809967

2006-01-01

109

Three-Day Combination Treatment for Vulvovaginal Candidosis with 200?mg Clotrimazol Vaginal Suppositories and Clotrimazol Cream for the Vulva is Significantly Better than Treatment with Vaginal Suppositories Alone – an Earlier, Multi-Centre, Placebo-Controlled Double Blind Study  

PubMed Central

Problem: According to the guidelines, acute vulvovaginal candidosis (VVC) may be treated vaginally, through a combination of vaginal treatment and cream for the vulva or orally. However, there is a lack of investigations into whether combined treatment for the vagina and vulva achieves better results than vaginal treatment alone. Method: In 1999, 160 patients with vulvovaginal candidosis from ten German gynaecological practices were included in a study and treated on a randomised basis with three 200?mg clotrimazol vaginal suppositories?=?clotrimazol 2?% cream (verum n?=?79) or + placebo (active-ingredient-free cream base n?=?79). The examinations took place before treatment (T1), six to eight days following the end of treatment (T2) and approximately four weeks following the end of treatment (T3). In addition to demographic data, the clinical findings of each investigation were documented in a standardised way and a native preparation and a fungal culture were taken. The doctor and patient evaluated the healing process and tolerance. The main efficacy variables were the pre/post difference scores for extravaginal redness. Results: On T1, there was no difference between the two groups. By T2, there was a significant difference in the extent of extravaginal redness between the verum and the placebo groups (p?=?0.0002), as well as in the subgroup of the per-protocol analysis (verum 64, placebo 70 patients, p?=?0.0015). Genital itching or burning had entirely disappeared in 51?% and 56?% of patients respectively in the verum group and in only 30?% and 45?% of patients in the placebo group on T2 (p?=?0.0181). There was no difference in intravaginal redness on T1 and T2 in either group. The overall assessment by the doctor went accordingly (p?=?0.0004). On T1, the extravaginal fungal culture was positive in 75 women in the verum group and in 76 women in the placebo group. On T2, however, this was positive in 51.9?% (verum) and 73.1?% (placebo) of cases, and a positive culture was evinced in the vagina in 6 vs. 8 women (7.5 vs. 10.1?%, p?=?0.3802). The local tolerance in both groups was 70?% very good, and 29 vs. 27?% good. After four weeks (T3), 16 out of 23 patients in the verum group and only 8 out of 21 in the placebo group had negative extravaginal fungal cultures. Discussion: There is a lack of studies into the issue of whether vaginal treatment or combined vulvovaginal treatment of acute VVC would be more advantageous. However, there are two studies that support the significant results of this paper that when it comes to acute VVC, the combination of three 200?mg clotrimazol vaginal suppositories with clotrimazol cream 2?% is better than with vaginal suppositories alone. PMID:25076792

Mendling, W.; Schlegelmilch, R.

2014-01-01

110

AML M7 Misdiagnosed as ALL.  

PubMed

Hematogones, which are normal precursors of B lymphocytes in the bone marrow, may be mistaken for blast cells on flow cytometry and histology when their numbers increase. We report such a case in a 16 months old male who was unsuccessfully treated for a pre-B cell ALL on the basis of flow cytometry of the bone marrow which showed a substantial population of CD19 and CD10 expressing 'blast' cells. A diagnosis of AML M7 was made on a subsequent bone marrow biopsy in which the blast cells expressed CD61 and Factor VIII, while they were negative for CD10 and CD20. Also present were a few CD10 and CD20 expressing small lymphoid cells, which were interpreted as hematogones. This report reiterates the problem of mistaking hematogones for 'blast' cells on flow cytometry, especially in the marrow of very young children where hematogones are often prominent. PMID:25332577

Chaudhari, Jayashri; Borges, Antia; Bansal, Shweta; Mahajan, Pravin

2014-09-01

111

Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenomation  

PubMed Central

The authors present a case report of a 17-month-old female child who ingested a large amount of methamphetamine that looked very similar clinically to a scorpion envenomation specific to the southwestern United States by the species Centruroides sculpturatus. The child was initially treated with 3 vials of antivenom specific for that scorpion species and showed a transient, though clinically relevant neurologic improvement. Her clinical course of sympathomimetic toxicity resumed and she was treated with intravenous fluids and benzodiazepines after blood analysis showed significant levels of d-methamphetamine. This case report is to specifically underline the clinical confusion in discerning between these two conditions and the realization of limited and/or expensive resources that may be used in the process. PMID:25649670

Strommen, Joshua; Shirazi, Farshad

2015-01-01

112

Cerebral Vein Thrombosis Misdiagnosed and Mismanaged  

PubMed Central

Cerebral venous thrombosis (CVT) should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management. PMID:22567255

Sasidharan, P. K.

2012-01-01

113

Adults With Asperger Disorder Misdiagnosed as Schizophrenic  

Microsoft Academic Search

Psychologists have a prominent role in the diagnosis and treatment of developmental disorders. With the inclusion of Asperger disorder in the DSM–IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; American Psychiatric Association, 1994), there is an explosion of interest in mild autistic disorders. This syndrome, which is characterized by problems in interpersonal relatedness, empathic communication, and imagination, has

Lawrence Perlman

2000-01-01

114

Cardiac asystoles misdiagnosed as epileptic seizures.  

PubMed

We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17?s after the beginning of asystole. Synus rhythm reappeared 32?s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred. PMID:25628317

Chiesa, Valentina; Vignoli, Aglaia; Canevini, Maria Paola

2015-01-01

115

[Angiomiofibroblastoma of the vulva. Report of case].  

PubMed

Angiomyofibroblastoma is a benign mesenchymal tumor of the lower genital tract described in 1992 by Fletcher and his group. Must be differentiated mainly from aggressive angiomyxoma, which has a high local recurrence rate. We report the case of a 21 year old patient who attended the General Hospital Dr. Miguel Silva, in Morelia, Michoacan, because post-term pregnancy of 41.1 weeks gestation, with a bulky vulvar tumor, asymptomatic with four years of evolution. Cesarean section and vulvar tumor resection were performed. The surgical specimen measured 14 x 10 x 5 cm, had a polypoid aspect, multilobulated, with nodules of varying size. From a microscopic point of view the tumor was well defined, formed by loose connective tissue septa, with stromal fusiform cells and benign characteristics, between collagen fibers, with abundant vessels. The histochemical studies were positive for desmin and vimentin. These anatomopathological findings are diagnostic of vulvar angiomyofibroblastoma, benign course tumor, does not resort nor does it generate metastases after simple surgical resection; however, recurrence in the vagina is reported. Must be differentiated from other mesenchymal neoplasms of the genital tract. PMID:23837300

Pérez-Martínez, Andrés; Chávez-Martínez, Sareni; Sereno-Coló, José Antonio; Arias-González, María Leilanie

2013-06-01

116

Surgery for Cancer of the Vulva (Vulvectomy)  

MedlinePLUS

... become a long-term problem. This condition, called lymphedema, can cause pain, a feeling of heaviness, and ... them. (If you want to read more about lymphedema in the groin or legs, you can get ...

117

Visual hallucinations from retinal detachment misdiagnosed as psychosis.  

PubMed

Hallucinations are a common presenting symptom in schizophrenia and other psychotic disorders. In particular, auditory hallucinations, such as hearing voices, are the most common type of hallucination described in schizophrenia, while visual hallucinations are less frequently seen. Hallucinations are also present in disorders that are not primarily psychotic in nature, including mood disorders, substance-induced disorders, and psychosis due to a general medical condition. However, it is extremely important to rule out general medical causes of hallucinations, as they are often treatable and reversible, and if left untreated, the underlying non-psychiatric disorders causing them can lead to irreversible damage. We present a case in which a 48-year-old woman with schizophrenia began to complain of visual disturbances. Because of her delusional interpretation of these disturbances, they were initially attributed to psychosis, but the disturbances were in fact found to be the result of a retinal detachment. PMID:21430493

Brda, David; Tang, Eric Chun-Hin

2011-03-01

118

Congenital chloride diarrhea misdiagnosed as pseudo-Bartter syndrome  

PubMed Central

Congenital chloride diarrhea (CCD) is a rare autosomal recessive disease which is characterized by intractable diarrhea of infancy, failure to thrive, high fecal chloride, hypochloremia, hypokalemia, hyponatremia and metabolic alkalosis. In this case report, we present the first female and the second official case of CCD in Iran. A 15-month-old girl referred to our hospital due to failure to thrive and poor feeding. She had normal kidneys, liver and spleen. Treating her with Shohl's solution, thiazide and zinc sulfate did not result in weight gain. Consequently, pseudo-Bartter syndrome was suspected, she was treated with intravenous (IV) therapy to which she responded dramatically. In addition, hypokalemia resolved quickly. Since this does not usually happen in patients with the pseudo-Bartter syndrome, stool tests were performed. Abnormal level of chloride in stool suggested CCD and she was thus treated with IV fluid replacement, Total parentral nutrition and high dose of oral omeprazole (3 mg/kg/day). She gained 1 kg of weight and is doing fine until present. CCD is a rare hereditary cause of intractable diarrhea of infancy. It should be considered in infants with unknown severe electrolyte disturbances. PMID:24381629

Saneian, Hossein; Bahraminia, Emad

2013-01-01

119

Lymphogranuloma venereum and HIV infection: misdiagnosed as Crohn's disease  

PubMed Central

The report describes a young Caucasian homosexual man who presented with a 4-month history of bloody diarrhoea and weight loss. Over the next 4 months he was investigated for inflammatory bowel disease and subsequently started on mesalazine and prednisolone as an outpatient. Within a month of starting treatment his symptoms worsened, leading to his self-referral to the genitourinary medicine clinic. The patient was subsequently diagnosed with advanced HIV infection and lymphogranuloma venereum infection. The patient was treated with doxycycline for 3 weeks and started on antiretrovirals. One month later the patient is symptom free with a recovering immune system. PMID:22797476

Patel, Sheel; Hay, Phillip

2010-01-01

120

[Dystrophia myotonica (Steinert disease)--a frequently misdiagnosed disease].  

PubMed

Dystrophia myotonica (Steinert's disease) is the most common hereditary disease of the neuromuscular system in adults. Its mode of inheritance is autosomal dominant. The gene responsible for its is located on chromosome 19 in the linkage domain of the loci for the apolipoproteins C2, C1 und E and of the creatine kinase of skeletal muscle (CKMM). Myotonic dystrophy is categorized in an adult and in a congenital form. In the adult form, the characteristic findings are muscular atrophy in certain regions of the body (face, neck and distally in the extremities) and myotonia. Cataract, intraocular hypotension, gonadal atrophy, conduction abnormalities in the heart and hearing deficiencies appear quite often in the course of the disease. In the congenital form, general muscle weekness (particularly pronounced in the face) is the leading finding, combined with retarded loco motor and mental development. A decisive criterion for the diagnosis of this form is the occurrence of myotonic dystrophy in the patient's mother. Electromyographic investigation is indicated when a suspicion of myotonic dystrophy cannot be ascertained on the basis of clinical and genetic findings. Myotonic runs in the EMG will then corroborate the suspicion. Recent electrophysiological investigations have indicated that at least three different types of channels for the passage of ions through the membrane of the skeletal muscle cells show abnormal behaviour, i.e. the channel for Cl-, Na+ and K+. These findings corroborate the hypothesis that the abnormality responsible for myotonic dystrophy is situated in the membrane systems. A pharmacological treatment of the muscular dystrophy has not yet been developed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2198475

Kuhn, E; Lehmann-Horn, F; Rüdel, R

1990-06-01

121

Peroneal neuropathy misdiagnosed as L5 radiculopathy: a case report  

PubMed Central

Objective The purpose of this case report is to describe a patient who presented with a case of peroneal neuropathy that was originally diagnosed and treated as a L5 radiculopathy. Clinical features A 53-year old female registered nurse presented to a private chiropractic practice with complaints of left lateral leg pain. Three months earlier she underwent elective left L5 decompression surgery without relief of symptoms. Intervention and outcome Lumbar spine MRI seven months prior to lumbar decompression surgery revealed left neural foraminal stenosis at L5-S1. The patient symptoms resolved after she stopped crossing her legs. Conclusion This report discusses a case of undiagnosed peroneal neuropathy that underwent lumbar decompression surgery for a L5 radiculopathy. This case study demonstrates the importance of a thorough clinical examination and decision making that ensures proper patient diagnosis and management. PMID:23618508

2013-01-01

122

Ectopic intrathyroidal thymus misdiagnosed as a thyroid nodule: sonographic appearance.  

PubMed

An 11-year-old boy under suppression therapy for a solitary thyroid nodule was referred for sonographic examination. The diagnosis had been made at another institution, based only on sonography without cytopathologic verification. A small fusiform lesion, which was homogeneously hypoechoic with diffuse bright internal echoes, was demonstrated in the right lower pole of the thyroid. A normal elongated thymus with a cervical component was then found connected to the thyroid with an accessory lobe, which was embedded in the lower thyroid pole mimicking a solitary nodule. We discuss the developmental abnormalities of the thymus and their clinical significance in childhood with a brief review of the literature. PMID:18361463

Megremis, Stylianos; Stiakaki, Eftichia; Tritou, Ioanna; Bonapart, Ingrid Elizabeth; Tsilimigaki, Amalia

2008-09-01

123

Misdiagnosing the Teacher Quality Problem. CPRE Policy Briefs. RB-49  

ERIC Educational Resources Information Center

This issue of CPRE Policy Briefs summarizes the findings on issues related to teacher quality in the chapter by the author in the book, "The State of Education Policy Research" (Cohen, Fuhrman, Mosher, Eds., 2007). This report also draws on discussions that took place during a summer, 2006, policy briefing on teacher labor-market issues held in…

Ingersoll, Richard M.

2007-01-01

124

Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain.  

PubMed Central

The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been avoided if awareness of these conditions had led to a correct diagnosis upon initial physical examination. PMID:1448407

Arroyo, J. F.; Jolliet, P.; Junod, A. F.

1992-01-01

125

MYH9 related platelet disorders - often unknown and misdiagnosed.  

PubMed

MYH9 related platelet disorders are a relatively rare cause of thrombocytopenia. Located on chromosome 22, the MYH9 gene encodes the motorprotein non-muscular myosin heavy chain IIA (NMMHCIIA). Heterozygous defects in this gene lead to 4 different autosomal dominant syndromes namely May-Hegglin anomaly, Epstein syndrome, Fechtner syndrome and Sebastian platelet syndrome. All 4 syndromes are characterized by macrothrombocytopenia and a mild bleeding tendency. Depending on the position of the causative mutation within the gene, the risk increases for syndromic manifestations such as renal failure, hearing loss and pre-senile cataract. Mutations in the neck region of the NMMHCIIA protein are more likely associated with these comorbidities than mutations in the N- or C-terminal part of the gene. MYH9 related platelet disorders should be excluded in patients with chronic thrombocytopenia and large platelets. Most sensitive for diagnosis/exclusion are immunofluorescence studies using a blood smear. The biggest risk for these patients is ineffective but potentially harmful treatment based on the misdiagnosis of immune thrombocytopenia. This review provides a workflow for diagnosis and treatment of MYH9 related thrombocytopenia. PMID:21567368

Althaus, K; Najm, J; Greinacher, A

2011-05-01

126

The role of blood pressure variability in misdiagnosed clinic hypertension  

Microsoft Academic Search

Blood pressure (BP) assessment may be vulnerable to bias by increased BP variability. Uncertainty in determining BP control is inherent to the clinic setting. We analyzed a registry of 3949 patients referred for ambulatory BP monitoring. The difference between clinic and ambulatory readings was plotted against ambulatory BP variability, assessed by standard deviation. In addition, BP variability of patients with

Amos Cahan; Iddo Z Ben-Dov; Judith Mekler; Michael Bursztyn

2011-01-01

127

Kennedy disease misdiagnosed as polymyositis: a case report  

PubMed Central

Background Polymyositis is an immune-mediated myopathy with clinical features of proximal muscle weakness. Dysphagia and neck flexor weakness can develop along with respiratory muscle weakness as the disease progresses. Kennedy disease or X-linked spinobulbar muscular atrophy is a rare X-linked recessive disorder with clinical features of slowly progressive atrophy and weakness of limb and bulbar muscles. These two disorders may have overlapping clinical manifestations. Case presentation We present the case of a 52-year-old Filipino man with chronic weakness involving his proximal muscle groups who carried the diagnosis of polymyositis and was refractory to multiple immunomodulatory therapies. Further neurologic examination and history taking along with selective serologic and electrodiagnostic studies instead confirmed the diagnosis of Kennedy disease. Conclusions Distinction between polymyositis and Kennedy disease may be difficult given the potential overlapping clinical manifestations. However, with careful neurological history taking, examination, and selective serologic plus electrodiagnostic investigations the correct diagnosis may be made, thus sparing the patient ineffective therapy. One must always be sure of the diagnosis of polymyositis before it’s classified as refractory. PMID:24073646

2013-01-01

128

Aggressive angiomyxoma of the vulva: A case report  

PubMed Central

Aggressive angiomyxoma (AA) is an unusual mesenchymal tumor. AA occurs most commonly in women of reproductive age and is located in the perineal or pelvic region. This is a distinct soft tissue tumor that has a prominent myxoid matrix and numerous thin-walled blood vessels and may have an aggressive local recurrence. The tumors have the characteristics of large size (usually greater than 10 cm) and slow growth, and are not painful. The standard treatment for AA is total excision and close follow-up. We announce a case of a 35 year-old female presenting with a pedunculated AA on the right labium majora that has not relapsed for seven years. PMID:24678492

Lee, Kyoung-A; Seo, Jung-Won; Yoon, Na-Ra; Kim, Byoung-Gie; Bae, Duk-Soo

2014-01-01

129

Aggressive angiomyxoma of the vulva: A case report.  

PubMed

Aggressive angiomyxoma (AA) is an unusual mesenchymal tumor. AA occurs most commonly in women of reproductive age and is located in the perineal or pelvic region. This is a distinct soft tissue tumor that has a prominent myxoid matrix and numerous thin-walled blood vessels and may have an aggressive local recurrence. The tumors have the characteristics of large size (usually greater than 10 cm) and slow growth, and are not painful. The standard treatment for AA is total excision and close follow-up. We announce a case of a 35 year-old female presenting with a pedunculated AA on the right labium majora that has not relapsed for seven years. PMID:24678492

Lee, Kyoung-A; Seo, Jung-Won; Yoon, Na-Ra; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

2014-03-01

130

Recurrent aggressive angiomyxoma of the vulva - a rare presentation.  

PubMed

We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its' recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date. PMID:24995218

Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Roy, Hironmoy; Sarkar, Amarendra Nath

2014-05-01

131

Aggressive angiomyxoma of the vulva: An uncommon entity.  

PubMed

Aggressive angiomyxoma is a rare, locally invasive mesenchymal tumor occurring usually in women of reproductive age, which carries a high risk for local relapse; hence the need to differentiate it from the other mesenchymal tumors occurring in this region. We describe a case of a 44-year-old female presenting with a large pedunculated swelling on the right labia majora. PMID:23130288

Kura, Mahendra M; Jindal, Saurabh R; Khemani, Usha N

2012-05-01

132

Vulvar Dermatoses – Irritant and Allergic Contact Dermatitis of the Vulva  

Microsoft Academic Search

Irritant and allergic contact dermatitis are commonly seen in patients complaining about itching, burning and irritation in the vulvar area. Irritation often precedes allergic sensitization. Clinically, irritant and allergic contact dermatitis can be difficult to distinguish. Diagnosis is made by history, clinical investigation and patch testing. Recommended patch test series are the standard series, a medicament series, the patient’s own

A. Bauer; C. Rödiger; C. Greif; M. Kaatz; P. Elsner

2005-01-01

133

[Benign tumors of vulva: review and case report of achrocordon].  

PubMed

The vulvovaginal region is a very complex area because of its anatomy and the fact that it can be source of a large number of benign tumors and less frequent malignant tumors. In recent decades, there have been significant gains in the diagnosis and treatment of vulvovaginal tumors, thanks to the contributions of cellular and molecular biology. The purpose of this review article is to serve as a practical reference for clinical and pathological diagnosis as well as in the outpatient treatment and monitoring of these benign tumors. PMID:25191903

Galeana, Cuauhtémoc; Casas, Donovan; Rodríguez, Alejandra; Cantú, Marco Antonio; Aguilar, Fabiola; Moreno, Víctor; Galindo, María Estela; Gutiérrez, Eduardo Ernesto

2014-01-01

134

Recurrent Aggressive Angiomyxoma of The Vulva – A Rare Presentation  

PubMed Central

We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its’ recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date. PMID:24995218

Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Sarkar, Amarendra Nath

2014-01-01

135

Using hip measures to avoid misdiagnosing early rapid onset osteoarthritis for osteonecrosis.  

PubMed

In the early phases, subchondral insufficiency fractures and rapidly destructive osteoarthritis of the hip are often mistaken for osteonecrosis of the hip. Three hip measures were used comparing combined subchondral insufficiency fractures and rapidly destructive 18 osteoarthritis patients to 18 osteonecrosis patients. Due to the rarity of these conditions there was no statistical power. Initial diagnoses for the osteoarthritis patients were recorded. The osteoarthritis group had significantly higher means for Tönnis angle (P < 0.001), lateral center edge angle (P = 0.006), and acetabular extrusion index (P = 0.014). Only 7 of the 18 patients were initially diagnosed without reservation as subchondral insufficiency fracture or rapidly destructive osteoarthritis. Using hip measures will reduce the misdiagnosis of rapid onset osteoarthritis of the hip for osteonecrosis. PMID:24360489

Nelson, Fred R T; Bhandarkar, Varun S; Woods, Tammy A

2014-06-01

136

IgG4-related sclerosing disease: an emerging entity frequently misdiagnosed.  

PubMed

IgG4-related sclerosing disease, a multiorgan system disease that has been identified in the last 10 years, is a fibroinflammatory condition with a marked propensity to manifest itself as mass forming lesions characterized by three main histological features (sclerosis, obliterative phlebitis and lymphoplasmacytic infiltrate) and by the presence of abundant IgG4+ plasma cells, frequent elevation of serum IgG4 and a dramatic initial response to steroid therapy. The aim of this mini-review is to increase the capacity to identify the characteristic features of IgG4-related sclerosing disease in specific organs and in two newly proposed entities (urethral caruncle and paratesticular fibrous pseudotumor) using biopsy specimens and methods of counting IgG4. In addition we examine the relationship between IgG4-related sclerosing disease and malignancy. In fact, an increased ability to recognize the characteristic features of IgG4-related sclerosing disease would play an extremely important role in avoiding unnecessary surgery in favor of initiating corticosteroid therapy. PMID:24341121

Mazzucchelli, Roberta; Racchini, Stefano; Barbisan, Francesca; Galosi, Andrea B; Giorgini, Sara

2013-08-01

137

Child abuse and osteogenesis imperfecta: how can they be still misdiagnosed? A case report.  

PubMed

Osteogenesis imperfecta (OI) is a rare hereditary disease caused by mutations in genes coding for type I collagen, resulting in bone fragility. In literature are described forms lethal in perinatal period, forms which are moderate and slight forms where the only sign of disease is osteopenia. Child abuse is an important social and medical problem. Fractures are the second most common presentation after skin lesions and may present specific patterns.The differential diagnosis between slight-moderate forms of OI and child abuse could be very challenging especially when other signs typical of abuse are absent, since both could present with multiple fractures without reasonable explanations. We report a 20 months-old female with a history of 4 fractures occurred between the age of three and eighteen months, brought to authorities' attention as a suspected child abuse.However when she came to our department physical examination, biochemical tests, total body X-ray and a molecular analysis of DNA led the diagnosis of OI.Thus, a treatment with bisphosphonate and a physical rehabilitation process, according to Vojta method, were started with improvement in bony mineralization, gross motor skills and absence of new fracture.In conclusion our case demonstrates how in any child presenting fractures efforts should be made to consider, besides child abuse, all the other hypothesis even the rarest as OI. PMID:23289038

D'Eufemia, Patrizia; Palombaro, Marta; Lodato, Valentina; Zambrano, Anna; Celli, Mauro; Persiani, Pietro; De Bari, Maria Pia; Sangiorgi, Luca

2012-09-01

138

Pharmacoresistant partial-onset epilepsy misdiagnosed as panic disorder: a case report.  

PubMed

The clinical differentiation between simple partial epileptic seizures of temporal lobe origin and panic attacks is often difficult on clinical grounds alone, because both conditions are characterized by common symptomatology which includes the feeling of fear, autonomic system dysfunction, disorientation and alternation of the level of consciousness when these conditions evolve clinically. The symptoms stem from common pathophysiologic and anatomic substrates of these two conditions, localized in the limbic system, especially the amygdala. We present the case of a young woman who had a febrile seizure in childhood and subsequent episodes of fear accompanied by tremor and possible alteration of consciousness followed by headache. These spells were diagnosed as panic attacks during her teenage years and she was given Clobazam in order to suppress them. The patient responded well for several years without attacks but her symptoms reappeared following discontinuation of her medication in order to conceive. At that time a detailed history was taken from her spouse and further clinical evaluation raised the suspicion of seizures especially due to the fact that her spells were characterized by alteration of consciousness; she was therefore referred for additional investigations which included admission to a monitoring unit for epilepsy. Long-term video-EEG recording revealed the presence of simple partial seizures with secondary generalization confirming the clinical impression. She was subsequently treated with antiepileptic medications; however the patient's condition worsened to the point where she became pharmacoresistant having failed several antiepileptic drug trials in monotherapy or combination. An MRI scan of the brain revealed the presence of right-sided mesial temporal sclerosis, a known consequence of febrile seizures. Her seizures were nocturnal tonic-clonic and gradually worsened to the point of occurring during most nights. She was therefore referred for a presurgical evaluation which confirmed that the epileptic focus was associated with the area of mesial temporal sclerosis. The epileptic focus was successfully removed from the right anterior temporal lobe and since then she remained free of seizures whereas, in addition, the presumed symptoms of panic attacks also resolved. This case indicates the occasional difficulty in diagnosing simple partial seizures and how it may be confused with psychiatric conditions. Therefore, the treating physician, especially the psychiatrist, should remain vigilant when treating cases of panic attacks, especially when they present with either atypical symptomatology, such as the case described, or when they do not respond to appropriately chosen treatment; such cases may warrant referral for further investigation. PMID:25367666

Papacostas, S S; Myrianthopoulou, P; Georgiades, S; Papathanasiou, E S

2014-01-01

139

Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis  

SciTech Connect

We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. (Univ. of Alabama, Birmingham (USA))

1991-07-01

140

A Case of Misdiagnosed Cesarean Scar Pregnancy with a Viable Birth at 28 Weeks  

PubMed Central

We report our experience with a case of presumptive cesarean scar pregnancy, based on detection of a gestational sac (GS) in early pregnancy at the site of a previous cesarean scar. The GS grew into the uterine cavity as the pregnancy progressed, showing an ultrasound image similar to that of a normal pregnancy. Thus, the pregnancy continued, resulting in a viable birth at 28 weeks of gestation. Cesarean scar pregnancy is classified as myometrial implantation or implantation growth into the uterine cavity. In the latter type, the gestational sac moves upward with increasing gestational weeks and it shows the same ultrasound image as a normal pregnancy. Therefore, the diagnosis must be made in the early pregnancy. PMID:25371837

Nukaga, Sakiko; Aoki, Shigeru; Kurasawa, Kentaro; Takahashi, Tsuneo; Hirahara, Fumiki

2014-01-01

141

Misdiagnosed male breast cancer with an unknown primary tumor: A case report.  

PubMed

Compared with female breast cancer, male breast cancer (MBC) has an extremely low morbidity, later staging and fewer breast tissues. The lumps are easier to invade in the center and the majority of the cases are positive for metastatic lymph node, with the typical clinical manifestation as a painless mass in partial breast. MBC with an unknown primary tumor is rare and is often prone to misdiagnosis, resulting in a delay in correct treatment. Such a case is extremely significant for clinical reference. The current study presents a 58-year-old male who developed a painless mass in the left armpit and received armpit mass biopsy and pathological examination which showed glandular cancer, with a high possibility of mammary primary tumor. The patient was administered four cycles of paclitaxel plus oxaliplatin chemotherapy. However, three months later, the patient identified novel disseminated lymph nodes in the left armpit. The initial pathological section and paraffin blocks were re-examined and the patient was finally diagnosed with breast invasive ductal carcinoma based on the metastases pathology and immunohistochemical examination. No breast mass was found on physical examination of the patient and the tumor markers, including cancer antigen 125 and carcinoembryonic antigen, were normal. No primary tumors were observed in the mammography and PET-CT and the primary tumor was not found following the left breast modified radical mastectomy. PMID:24959243

Wang, Wen-Wu; Chen, Lang; Ouyang, Xue-Nong

2014-07-01

142

A case of intradural-extramedullary form of primary spinal cysticercosis misdiagnosed as an arachnoid cyst.  

PubMed

We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases. PMID:25024830

Yoo, Minwook; Lee, Chang-Hyun; Kim, Ki-Jeong; Kim, Hyun-Jib

2014-04-01

143

A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst  

PubMed Central

We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases. PMID:25024830

Yoo, Minwook; Lee, Chang-Hyun; Kim, Hyun-Jib

2014-01-01

144

Misdiagnosed male breast cancer with an unknown primary tumor: A case report  

PubMed Central

Compared with female breast cancer, male breast cancer (MBC) has an extremely low morbidity, later staging and fewer breast tissues. The lumps are easier to invade in the center and the majority of the cases are positive for metastatic lymph node, with the typical clinical manifestation as a painless mass in partial breast. MBC with an unknown primary tumor is rare and is often prone to misdiagnosis, resulting in a delay in correct treatment. Such a case is extremely significant for clinical reference. The current study presents a 58-year-old male who developed a painless mass in the left armpit and received armpit mass biopsy and pathological examination which showed glandular cancer, with a high possibility of mammary primary tumor. The patient was administered four cycles of paclitaxel plus oxaliplatin chemotherapy. However, three months later, the patient identified novel disseminated lymph nodes in the left armpit. The initial pathological section and paraffin blocks were re-examined and the patient was finally diagnosed with breast invasive ductal carcinoma based on the metastases pathology and immunohistochemical examination. No breast mass was found on physical examination of the patient and the tumor markers, including cancer antigen 125 and carcinoembryonic antigen, were normal. No primary tumors were observed in the mammography and PET-CT and the primary tumor was not found following the left breast modified radical mastectomy. PMID:24959243

WANG, WEN-WU; CHEN, LANG; OUYANG, XUE-NONG

2014-01-01

145

Lupus Vulgaris Erythematoides: report of a patient initially misdiagnosed as dermatitis.  

PubMed

A small percentage of patients with tuberculosis present with cutaneous findings, which may be difficult to diagnose. We present a patient diagnosed with a rare, non-scarring form of cutaneous tuberculosis (CTB), classically termed as lupus vulgaris erythematoides. PMID:24011284

Vazquez-Lopez, Francisco; Fueyo-Casado, Alejandro; Gonzalez-Lara, Leire

2013-05-01

146

[Pseudo-Hakim-Adams syndrome. Neuropsychological study of 23 cases of misdiagnosed Hakim-Adams syndrome].  

PubMed

The authors study the characteristics of a group of 23 patients for whom an initial tentative diagnosis of Hakim-Adams syndrome (H-A syndrome) was eventually rejected. On account of several factors distinguishing these patients from the true H-A group, the authors propose using the term "pseudo Hakim-Adams syndrome". The distinguishing factors include: the grounds for admission, i.e. mental or mnesic deterioration, associated with radiological images of ventricular dilatation; a clinical picture dominated by mental disorders with only rare disorders of gait and sphincter control (several neurological defects were direct consequences of previous cerebral disease); no antecedents of spontaneous meningeal hemorrhage or meningitis in the case history; neuropsychological examination showing fewer disorders of concentration and less dyscalculia and constructive dyspraxia than in true HA, and far more atypical signs of the aphasic and anxio-depressive type. The authors think that various pathological processes may be responsible for this pseudo H-A syndrome in which a predominant mental picture is associated with ventricular dilatation. PMID:7136480

De Mol, J; D'Haens, J; Brihaye, J

1982-01-01

147

Bilateral acute depigmentation of the iris first misdiagnosed as acute iridocyclitis.  

PubMed

Acute depigmentation of the iris is a new condition characterized by pigment dispersion in the anterior chamber, depigmentation of the iris stroma, and pigment deposition in the anterior chamber angle. A 33-year-old woman using a topical corticosteroid every 2 h for the treatment of acute iridocyclitis was referred to our clinic to seek another opinion because her symptoms had not improved. An ocular evaluation of the patient revealed pigment precipitates on the corneal endothelium, pigment dispersion in the anterior chamber, symmetrical diffuse depigmentation, granularity of the iris stroma, and pigment deposition in the trabecular meshwork. These findings suggested a diagnosis of bilateral acute depigmentation of the iris (BADI) instead of iridocyclitis. Clinicians should be careful in the differential diagnosis of iris depigmentation from iridocyclitis to avoid the unnecessary use of high-dose topical corticosteroids. PMID:21633847

Goktas, Altan; Goktas, Sertan

2011-08-01

148

Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease  

PubMed Central

We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures. PMID:22848855

Nett, Randall J.; Book, Earl; Anderson, Alicia D.

2012-01-01

149

Acute intermittent porphyria caused by novel mutation in HMBS gene, misdiagnosed as cholecystitis  

PubMed Central

Background Acute intermittent porphyria (AIP) is an autosomal dominant neurovisceral inherited disorder due to a defect in the heme biosynthesis pathway. Misdiagnosis of the porphyrias is not uncommon. Case report We present a case of a 26-year-old female with suspected acute cholecystitis, mental status changes, and seizures. Biochemical and molecular investigations confirmed the diagnosis of AIP by findings of elevated urinary porphobilinogen, 5-aminolevulinic acid, and total porphyrins. DNA molecular testing showed a novel heterozygous mutation (c. 760delC p.L254X) in the exon11 of the HMBS gene. To the best of our knowledge, this is the first report of a misdiagnosis of AIP presenting with acute cholecystitis. Conclusion Clinicians are alerted to consider the possibility of AIP in an adult presenting with an acute abdomen, features of cholecystitis, and neuropsychiatric manifestations. PMID:25419136

Alfadhel, Majid; Saleh, Neam; Alenazi, Helal; Baffoe-Bonnie, Henry

2014-01-01

150

Subcutaneous panniculitis-like T-cell lymphoma misdiagnosed as lupus erythematosus panniculitis  

Microsoft Academic Search

We report a case of subcutaneous panniculitis-like T-cell lymphoma (SPTCL), associated with macrophage activation syndrome,\\u000a mimicking a lupus erythematosus panniculitis (LEP). A 29-year-old woman presented with high fever, general malaise, nausea,\\u000a vomiting, and subcutaneous nodules and ulcerating lesions located on the lower extremities. The histopathology showed an infiltration\\u000a of the panniculus, mostly involving fat, and periadnexial and perivascular structures consistent

Estrella Garcia Gonzalez; Enrico Selvi; Sauro Lorenzini; Roberta Maggio; Susanna Mannucci; Mauro Galeazzi; Roberto Marcolongo

2007-01-01

151

Congenital mitral valve regurgitation in adult patients. A rare, often misdiagnosed but repairable, valve disease  

Microsoft Academic Search

Objective: Congenital mitral valve regurgitation (MVR) is a rare disease occurring in infancy or childhood. Although congenital MVR has been described in adults, no surgical series has been reported so far. We describe here a 6-year surgical experience of congenital MVR in adults at a single institution. Methods: We reviewed the data of 15 consecutive patients (8 men), aged more

Rachid Zegdi; Brahim Amahzoune; Mustapha Ladjali; Ghassan Sleilaty; Jérome Jouan; Christian Latrémouille; Alain Deloche; Jean-Noël Fabiani

2008-01-01

152

Child abuse and osteogenesis imperfecta: how can they be still misdiagnosed? A case report  

PubMed Central

Summary Osteogenesis imperfecta (OI) is a rare hereditary disease caused by mutations in genes coding for type I collagen, resulting in bone fragility. In literature are described forms lethal in perinatal period, forms which are moderate and slight forms where the only sign of disease is osteopenia. Child abuse is an important social and medical problem. Fractures are the second most common presentation after skin lesions and may present specific patterns. The differential diagnosis between slight-moderate forms of OI and child abuse could be very challenging especially when other signs typical of abuse are absent, since both could present with multiple fractures without reasonable explanations. We report a 20 months-old female with a history of 4 fractures occurred between the age of three and eighteen months, brought to authorities’ attention as a suspected child abuse. However when she came to our department physical examination, biochemical tests, total body X-ray and a molecular analysis of DNA led the diagnosis of OI. Thus, a treatment with bisphosphonate and a physical rehabilitation process, according to Vojta method, were started with improvement in bony mineralization, gross motor skills and absence of new fracture. In conclusion our case demonstrates how in any child presenting fractures efforts should be made to consider, besides child abuse, all the other hypothesis even the rarest as OI. PMID:23289038

D’Eufemia, Patrizia; Palombaro, Marta; Lodato, Valentina; Zambrano, Anna; Celli, Mauro; Persiani, Pietro; De Bari, Maria Pia; Sangiorgi, Luca

2012-01-01

153

Crohn's disease of the vulva in a 10-year-old girl.  

PubMed

Crohn's disease may involve all parts of the gastrointestinal tract and may often involve other organs as well. These non-intestinal affections are termed extraintestinal manifestations. Vulval involvement is an uncommon extraintestinal manifestation of Crohn's disease, and it is very rare in children. Patients with vulval CD typically present with erythema and edema of the labia majora, which progresses to extensive ulcer formation. Vulval Crohn's disease can appear before or after intestinal problems or it may occur simultaneously. We present a 10-year-old girl with intestinal Crohn's disease complicated with perianal skin tags and asymptomatic unilateral labial hypertrophy. The course of her lesion was independent of the intestinal disease and responded significantly to medical treatment including azathioprine and topical steroid. We emphasize that although vulval involvement in childhood is uncommon, Crohn's disease must be considered in the differential diagnosis of nontender, red, edematous lesions of the genital area. PMID:18664090

Kulo?lu, Zarife; Kansu, Aydan; Demirçeken, Fulya; Bozkir, Mehtap; Kundakçi, Nihal; Bingöl-Kolo?lu, Meltem; Girgin, Nurten

2008-01-01

154

Influence of Treatment of Erosive Lichen Planus of the Vulva on Its Prognosis  

Microsoft Academic Search

Interventions: Patients received topical corticoste- roids with or without other topical preparations and sys- temic treatments as part of their normal care. Results:The mean age at onset of vulval symptoms was 56.9 years. First-line therapy was an ultrapotent topical corticosteroid in 89 women (78%), of whom 63 (71%) weresymptomfreewhilereceivingtreatment.Overalland with time, 86 women (75%) improved with treatment, including 62 (54%)

Susan M. Cooper; Fenella Wojnarowska

2006-01-01

155

Co-existence of extramammary Paget's disease and Bowen's disease of vulva.  

PubMed

Extramammary Paget's disease and Bowen's disease are histologically similar and immunohistochemistry is often required to make the diagnosis. We present a case of vulval Paget's disease with Bowen's disease in an elderly female. Strong positivity for cytokeratin 7, anti CAM 5.2, carcinoembryonic antigen (CEA) and periodic acid-Schiff (PAS) stain in clitoral, left labial and interface regions of the vulvectomy specimen confirmed the diagnosis of Paget's disease (PD) while positive staining for p63 in the right labial and interface regions helped in establishing the diagnosis of concurrent Bowen's disease (BD). PMID:25382511

Goyal, Tarang; Varshney, Anupam; Solanki, Ranjan

2014-01-01

156

Searching: the lived experience of women with cancer of the vulva.  

PubMed

Although the physical adverse effects following surgery for vulval cancer may readily be described, little is known about the psychological, emotional, and social impact. A review of the literature revealed a paucity of studies, as this condition is rare. To explore the lived experiences of women in the United Kingdom with vulval cancer, a qualitative research study was undertaken using the research methodology of interpretive phenomenology, based on the work of Heidegger (The Essence of Human Freedom. London: Continuum; 2005) and van Manen (Researching Lived Experience. Human Science for an Action Sensitive Pedagogy. New York: State University of New York Press; 1990). Thirteen women younger than 50 years were interviewed between 6 months and 5 years after their surgery, and the data were analyzed using framework analysis (Qualitative data analysis for applied policy research. In: Analysing Qualitative Data. London: Routledge; 1994:173-194). This article describes how the concept of searching emerged from the data. It also describes the manner in which the women searched to control their symptoms by their own efforts and by undergoing surgery. The search to understand the truth about their condition and their access to information in the search for meaning and the time element in which this was undertaken was also raised. An underlying consideration is the need for health professionals to help provide the information and support needed to manage this condition. PMID:19816158

Jefferies, Hilary; Clifford, Collette

2009-01-01

157

A patient with lichen sclerosus, Langerhans cell histiocytosis, and invasive squamous cell carcinoma of the vulva.  

PubMed

We report a patient with vulvar lichen sclerosus, Langerhans cell histiocytosis (LCH), and later vulvar cancer. In LCH, high amounts of non functional Langerhans cells are present in the affected tissue, making it possible that LCH may have contributed to vulvar cancer development in this patient. PMID:20541173

Simons, Michiel; Van De Nieuwenhof, Hedwig P; Van Der Avoort, Irene A M; Bulten, Johan; De Hullu, Joanne A

2010-08-01

158

Cytology of the vulva: feasibility and preliminary results of a new brush  

PubMed Central

Objective: Taking a biopsy is a standard procedure to make the correct diagnosis in patients with suspicious premalignant vulvar lesions. The use of a less invasive diagnostic tool as triage instrument to determine whether biopsy is necessary may improve patient comfort especially in patients with chronic vulvar disorders that may warrant consecutive biopsies. This study was conducted to investigate whether vulvar brush cytology is feasible and may be used to detect (pre)malignant vulvar lesions. Methods: A pilot study was performed with patients having clinically normal vulvar skin, lichen sclerosus (LS), usual or differentiated vulvar intraepithelial neoplasia or squamous cell carcinoma. A total of 65 smears were taken with the use of a vulvar brush and biopsies were performed for histopathological analysis. Results: Out of 65 smears, 17 (26%) were discarded because of poor cellularity. A total of 28 of 29 (97%) smears with a histological proven (pre)malignancy had a smear classified as ‘suspicious' or ‘uncertain'. Cytology classified 11 smears as ‘non-suspicious', of which 10 (91%) were indeed normal skin or LS. The accuracy, based on the presence of a lesion, for (pre)malignant lesions with the use of the brush showed a sensitivity of 97% and a negative predictive value of 88%. Conclusion: Vulvar brush cytology is feasible and may be a first step in the development of a triage instrument to determine whether subsequent biopsy of a clinically (pre)malignant lesion is necessary. PMID:22134509

van den Einden, L C G; Grefte, J M M; van der Avoort, I A M; Vedder, J E M; van Kempen, L C L T; Massuger, L F A G; de Hullu, J A

2012-01-01

159

Condyloma-like squamous cell carcinoma of the vulva: report of two midline cases  

PubMed Central

Vulvar cancer is uncommon and may be confused with genital condylomata. We report two cases of middle-aged women presenting with exophytic vulvar tumors of the midline for which diagnosis of a vulvar squamous cell carcinoma was confirmed by histopathology. Risk factors, staging, and treatment options are discussed. PMID:23055761

Verma, Shyam B; Wollina, Uwe

2012-01-01

160

Basal cell carcinoma of the vulva: a report of four cases.  

PubMed

Four cases of vulval basal cell carcinoma were identified in multiparous females aged 46-78 years. Symptoms included discomfort and pruritus ranging from 6 weeks to 4 years in duration. Such symptoms occurred in the context of a pink vulval plaque. The non-specific symptoms, in the context of the particular anatomical site, led to late presentation. Subsequent treatment in all cases involved wide local excision following incisional biopsy. No recurrence has been documented after a minimum follow-up period of 12 months. PMID:18855783

DeAmbrosis, Kathryn; Nicklin, James; Yong-Gee, Simon

2008-11-01

161

Aggressive angiomyxoma of the vagina: a case report.  

PubMed

Aggressive angiomyxoma is a rare, slow-growing soft tissue tumor that usually arises in the pelvis and perineal regions of women in reproductive age, with a marked tendency to local recurrence. Because of its rarity, it is often initially misdiagnosed. Surgical resection is the main treatment modality of aggressive angiomyxoma. We describe a case of a vaginal aggressive angiomyxoma in a 47-year-old woman in which the diagnosis was only made after histological examination. The etiology, presentation, diagnosis and management of this rare tumor are outlined. Angiomyxoma of vulva and vagina refers to a rare disease. Pre-operative diagnosis is difficult due to rarity and absence of diagnostic features, but it should be considered in every mass in genital, perianal and pelvic region in a woman in the reproductive age. Thus, these cases should have complete radiological workup before excision, as pre-diagnosis can change the treatment modality and patient prognosis'. PMID:24500513

Lourenço, Cátia; Oliveira, Nuno; Ramos, Filomena; Ferreira, Isabel; Oliveira, Mário

2013-12-01

162

Aggressive angiomyxoma: swirled configuration on ultrasound and MR imaging.  

PubMed

Aggressive angiomyxoma is a rare, myofibroblastic tumour, of pelvi-perineum of young women. It is a slow growing, low grade neoplasm with a high risk of recurrence following initial resection. Aggressive angiomyxoma is often clinically misdiagnosed because of its variable presentation as a soft tissue mass of the vulva, perianal region, buttock or pelvis. It displays translevator extension with growth around the perineal structures. Fewer than 150 cases have been reported in the literature since 1983. Imaging is important to determine the extent of the lesion. We present layered configuration of the mass on ultrasound and Magnetic Resonance Imaging in a 40 years old woman with a left pelvi- perineal mass since 5 years. Histapathology after excision gave a diagnosis of Aggressive Angiomyxoma. PMID:24864615

Tariq, Rukhsana; Hasnain, Shehla; Siddiqui, Maria Tariq; Ahmed, Rashid

2014-03-01

163

Adenoid Cystic Carcinoma of Bartholin’s Gland Clinically Mimics Endometriosis, A Case Report  

PubMed Central

Adenoid cystic carcinoma of Bartholin’s gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin’s glands. PMID:25429183

Akbarzadeh-Jahromi, Mojgan; Sari Aslani, Fatemeh; Omidifar, Navid; Amooee, Sedigheh

2014-01-01

164

A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome  

PubMed Central

Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available. PMID:24959370

Porter, J.; Al-Jarrah, Q.; Richardson, S.

2014-01-01

165

Misdiagnosed pneumothorax interpreted as necrotizing fasciitis of the chest wall: case report of a potentially preventable death  

PubMed Central

Background Subcutaneous emphysema is an uncommon clinical finding associated both with benign sources and potentially deadly necrotizing infections. Wide ranges of causes exist including trauma, iatrogenic injuries, factitious disorders and necrotizing infections. Case presentation A 49-year old male presented to the emergency room with extensive subcutaneous emphysema following blunt trauma. The orthopaedic surgery service was consulted for treatment of suspected necrotizing fasciitis due to his subcutaneous emphysema. A careful patient history and physical examination correlated with laboratory and radiographic findings revealed rib fractures and a long-standing, undiagnosed pneumothorax as the cause for emphysema. Treatment of the underlying condition with chest tubes led to eventual resolution of the emphysema, though multisystem organ failure ultimately resulted in patient death. Conclusion This case illustrates the importance of rapidly and appropriately evaluating trauma patients, and in this case specifically diagnosing and treating the underlying cause of subcutaneous emphysema. The late diagnosis of pneumothorax resulted in delayed definitive treatment, which may have contributed to the patient’s ultimate demise. In acute and sub-acute trauma situations a high level of suspicion for life threatening injuries must be maintained. Decision making for initial treatment should be based on the basic tenants of Advanced Trauma Life Support to primarily address these injuries and help prevent further disability or death. PMID:24834125

2014-01-01

166

Unbalanced interchromosomal insertion diagnosed prenatally by FISH, with carrier mother, previously misdiagnosed as having a balanced reciprocal translocation  

SciTech Connect

Insertion translocations are rare. A carrier with a balanced insertion translocation is most likely to be detected through offspring with an unbalanced translocation. We with to report a case where a correct diagnosis, made prenatally with FISH, corrected the initial misdiagnosis of the mother in another institute. PDL received an amniotic fluid sample from a 28 y.o. woman (G5P2Sab1TOP1) at 19 wks gestation. The indications were a reported balanced translocation, t(6;13), in the mother and a previous daughter with an unbalanced translocation. Chromosome analysis of the amniocytes showed a female karyotype with an abnormal chr. 13. Since the mother was diagnosed as having t(6;13)(q21;q34), the der(13) in the amniocytes was initially assumed to result from an adjacent segregation of the t(6;13). However, the banding patterns of this abnormal chr. 13 did not fit into the above defined translocation. With FISH and a chr. 13 painting probe, this der(13) was painted in the proximal and the distal thirds, but NOT in the middle region. This indicates that the middle section of the der(13) must have originated from 6q. The banding pattern is compatible with a direct insertion of 6q15 to 6q23.3 into 13q21.2. Thus, the fetus has partial trisomy 6q. After counseling, the mother elected to terminate the pregnancy but later changed her mind. An 8 lb 12 oz baby girl was born at 36 wks. (mother diabetic). Chromosome analysis of the newborn blood confirmed the dx. The mother was studied, using multicolor painting probes for chromosomes 13 and 6, a balanced direct insertion of 6q15 to 6q23.3 into chr. 13q21.2 was clearly shown. The previous affected daughter with a 13q+ is now 4 y.o. (a restudy is planned). She has microcephaly, severe developmental delay and other dysmorphic features. This case illustrates the advantage of using FISH to arrive at a definitive diagnosis of an insertion translocation.

Yu, M.T.; Leiber, E.; Qazi, Q. [and others

1994-09-01

167

Cavernous hemangioma of the cavernous sinus misdiagnosed as a meningioma: a case report and MR imaging findings.  

PubMed

Cavernous hemangioma (CH) is a benign vascular malformation. Intracranial CH is generally localized as an intracranial-intraaxial and responsible for 5-13% of all intracranial vascular malformations. Intracranial-extraaxial CHs are rare rather than intracranial-intraaxial CHs. Clinical findings, imaging characteristics, and surgical approach of extraaxial CHs are rather different than intraaxial CHs. Diagnosing cavernous sinus CH preoperatively is very important, but its radiological differential diagnosis is quite difficult. In this study, we present magnetic resonance imaging findings of a 48-year-old male who was considered preoperatively to have meningioma but was diagnosed with cavernous sinus CH during surgery by pathological examination. PMID:23453537

Hasiloglu, Zehra Isik; Asik, Murat; Kizilkilic, Osman; Albayram, Sait; Islak, Civan

2013-01-01

168

Hepatoerythropoietic Porphyria Misdiagnosed as Child Abuse: Cutaneous, Arthritic, and Hematologic Manifestations in Siblings with a Novel UROD Mutation  

PubMed Central

Background Hepatoerythropoietic porphyria (HEP) is a rare autosomal recessive disorder resulting from the markedly deficient, but not absent, activity of the heme biosynthetic enzyme, uroporphyrinogen decarboxylase (UROD). HEP typically manifests during infancy or early childhood with extreme photosensitivity, skin fragility in sun-exposed areas, hypertrichosis, erythrodontia, and pink urine. Observations We describe three siblings, offspring of parents of Puerto Rican and Dominican descent, who presented with excessive scarring on the face and dorsal aspect of the forearms, which initially led to the erroneous suspicion of child abuse. Although these lesions were photodistributed, overt photosensitivity had not been observed, with the exception of a single episode of blistering and onycholysis following intense sun exposure in one affected child. Mild facial hypertrichosis, chronic anemia, polyarticular arthritis, and developmental delay represented additional findings. Biochemical studies of urine, plasma, and erythrocyte porphyrins from the affected siblings established the diagnosis of HEP. Sequencing of the UROD gene revealed compound heterozygosity for a novel missense mutation, V166A, and a complex deletion/insertion, 645del1053ins10. Conclusions Our report expands the phenotypic and genotypic spectrum of HEP, highlighting mild cutaneous presentations that can occur without obvious photosensitivity and potentially masquerade as child abuse. PMID:20479301

Cantatore-Francis, Julie L.; Cohen, Jessica; Balwani, Manisha; Kahn, Philip; Lazarus, Herbert M.; Desnick, Robert J.; Schaffer, Julie V.

2011-01-01

169

[Update on current care guidelines. Diagnosis, treatment and follow-up of cytological changes in the cervix, vagina and vulva].  

PubMed

Approximately 150 cervical cancer cases are diagnosed in Finland annually. Both incidence and mortality have decreased by 80% since organised screening began. Recently, screening based on primary HPV-testing with Pap-smear triage has been shown to be more sensitive and more specific among women over 35 years old in randomised studies and thus may be implemented in routine. Abnormal findings in Pap smears indicate management. Confirmed CIN1 lesions are followed up and CIN2 and worse lesions treated. Follow-up after treatment should be reliably arranged, because elevated risk of cancer remains over 20 years after treatment. Quality control is of utmost importance. PMID:20957796

Pekka, Nieminen; Anttila, Ahti; Bützow, Ralf; Heikkilä, Elina; Hiltunen-Back, Eija; Mäenpää, Johanna; Puistola, Ulla; Rantanen, Virpi; Rintala, Marjut; Räisänen, Ilkka; Santalahti, Anne; Talvensaari-Mattila, Anne; Vartiainen, Juhani; Vuento, Maarit; Yliskoski, Merja

2010-01-01

170

Sodium Tetradecyl Sulphate Direct Intralesional Sclerotherapy of Venous Malformations of the Vulva and Vagina: Report of Five Cases  

SciTech Connect

We report five cases of female patients affected by symptomatic focal external genital venous malformations treated with percutaneous direct intralesional injection of sodium tetradecyl sulphate (STS). All patients were referred because of discomfort and pain when sexual intercourse was attempted. Direct sclerotherapy with 3% STS was performed on a day-hospital basis with the patient under local anesthesia. Complete resolution of the symptoms was achieved in all cases. No major adverse effects were reported. Direct intralesional sclerotherapy with STS may be considered a safe and effective method for the treatment of female external genital malformation without the necessity of general anesthesia for pain control.

Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Guy's and St. Thomas' NHS Trust, Department of Radiology (United Kingdom); Venetucci, Pietro [University Hospital 'Federico II', Department of Cardiovascular and Interventional Radiology (Italy); Hatzidakis, Adam [Medical School of Crete (Greece); Iaccarino, Vittorio [University Hospital 'Federico II', Department of Cardiovascular and Interventional Radiology (Italy)

2011-02-15

171

Premalignant epithelial disorders of the vulva: squamous vulvar intraepithelial neoplasia, vulvar Paget's disease and melanoma in situ.  

PubMed

No standard screening programs exist to detect vulvar carcinoma or its precursor lesions, and therefore gynecologists, dermatologists and other healthcare providers in this field should be aware of the clinical features, behavior and management of the different existing premalignant vulvar lesions, squamous vulvar intraepithelial neoplasia (VIN), vulvar Paget's disease and melanoma in situ. In 2004, a new classification for squamous VIN was introduced by the International Society for the Study of Vulvar Disease, subdividing squamous VIN into the HPV-related usual type, and into differentiated type, which is associated with lichen sclerosus. This review describes the relevant aspects of squamous VIN, vulvar Paget's disease and melanoma in situ, its epidemiological characteristics, diagnosis, management and malignant potential. PMID:20504079

Terlou, Annelinde; Blok, Leen J; Helmerhorst, Theo J M; van Beurden, Marc

2010-06-01

172

High levels of p53 expression correlate with DNA aneuploidy in (pre)malignancies of the vulva.  

PubMed

The molecular pathogenesis of human papilloma virus-unrelated vulvar squamous cell carcinoma is not well known. Whether malignant progression of lichen sclerosus and differentiated vulvar intraepithelial neoplasia to vulvar squamous cell carcinoma could be accompanied by altered DNA content has not been studied extensively. DNA content in isolated nuclei of microdissected normal vulvar epithelium (n = 2), lichen sclerosus (n = 9), differentiated vulvar intraepithelial neoplasia (n = 13), and squamous cell carcinoma (n = 17) from 22 patients was measured via DNA image cytometry. For additional analysis, 6 differentiated vulvar intraepithelial neoplasia lesions were selected, bringing the number of patients to 28. p53 expression was determined by immunohistochemistry on consecutive tissue sections. Thirty-eight percent (5/13) of differentiated vulvar intraepithelial neoplasia lesions and 65% (11/17) of squamous cell carcinomas were DNA aneuploid or tetraploid. In lesions that contained differentiated vulvar intraepithelial neoplasia and adjacent squamous cell carcinoma, the ploidy status of differentiated vulvar intraepithelial neoplasia did not exceed that of squamous cell carcinoma. We observed a strong correlation between high p53 expression and DNA aneuploidy. This relation was also present at the level of a single nucleus, measured by sequential image cytometry of p53 immunohistochemistry followed by DNA image cytometry on formalin-fixed tissue sections. Similarly, we found p53-positive nonproliferating cells with increased DNA content in the superficial compartment of 6 additional solitary differentiated vulvar intraepithelial neoplasia lesions that were not associated with squamous cell carcinoma, indicating ascending aneuploid cells from the basal compartment. DNA ploidy measurements suggest that differentiated vulvar intraepithelial neoplasia has a higher malignant potential than lichen sclerosus and thus is a more likely precursor of squamous cell carcinoma. Furthermore, high p53 expression correlates with increased DNA content and aneuploidy; but it requires further research to unveil a possible causal relation. PMID:20656324

van der Avoort, Irene A M; van de Nieuwenhof, Hedwig P; Otte-Höller, Irene; Nirmala, Ella; Bulten, Johan; Massuger, Leon F A G; van der Laak, Jeroen A W M; Slootweg, Piet J; de Hullu, Joanne A; van Kempen, Léon C L T

2010-10-01

173

Primary pulmonary amyloidosis misdiagnosed as malignancy on dual-time-point fluoro-deoxyglucose positron emission tomography/computed tomography: A case report and review of the literature  

PubMed Central

Primary pulmonary amyloidosis is an uncommon manifestation, characterized by amyloid deposition in the lungs and other associated tissue. The clinical presentation of amyloidosis is variable, with non-specific symptoms. The current study reports the case of a 59-year-old female presenting with primary pulmonary amyloidosis, indistinguishable from lung malignancy based on 18F-fluoro-deoxyglucose (18F-FDG) accumulation on dual-time-point (DTP) FDG-positron emission tomography/computed tomography (PET/CT) imaging and the similarities in morphological changes. A percutaneous CT-guided thoracoscopic biopsy was subsequently performed. Histological examination revealed that the specimens contained amorphous, homogeneous material with a number of polyclonal plasma cells, lymphocytes and giant cells. A diagnosis of primary nodular parenchymal pulmonary amyloidosis was determined, and the patient was discharged without chemotherapy. The patient remained in good clinical condition during follow-up. The present case indicated that localized nodular amyloidosis with increased FDG uptake on DTP FDG PET must be considered in the differential diagnosis of growing lung nodules, and that a histological examination must be conducted to distinguish this condition from malignancies of the lung.

DONG, MENG-JIE; ZHAO, KUI; LIU, ZHEN-FENG; WANG, GUO-LIN; YANG, JUN

2015-01-01

174

Acute management of aortoesophageal fistula and tracheoesophageal fistula treated by thoracic endovascular aortic repair and esophageal endoprosthesis: a case misdiagnosed as esophageal cancer.  

PubMed

Aortoesophageal fistula is rare but fatal if untreated. Open thoracic surgery is associated with high operative mortality and morbidity. We report a case of a 77-year-old man who, treated with thoracic endovascular aortic repair (TEVAR) for descending thoracic aneurysm in another center, after an acute episode of hematemesis and melena was referred to our center. The total body computed tomography scan showed the presence of reperfusion of the descending thoracic aneurysm sac (8.8 cm in diameter) in the proximal and distal TEVAR landing zone (endoleak type I) without clear signs of fistulous tract with the esophageal lumen. The patient underwent new TEVAR inside previous implantation with proximal landing very close to left subclavian artery and distal landing just above celiac trunk. For the presence of a tracheoesophageal fistula, an esophageal endoprosthesis was implanted few days later, and a jejunostomy was performed. At 30 days, patient was in good general condition, but he died at 3 months' follow-up. Aortoesophageal fistula is a rare and usually fatal condition; early recognition and TEVAR treatment prevent immediate exsanguination in patients, but after deployment of the endograft, most patients are at risk for infectious complications. Cessation of bleeding and restoration of circulation is of paramount urgency, but infectious diseases and esophageal repair remain open problems. PMID:22023952

Ferrero, Emanuele; Viazzo, Andrea; Ferri, Michelangelo; Rocca, Rodolfo; Pecchio, A; Piazza, Salvatore; Cumbo, Pia; Berardi, Giuseppe; Nessi, Franco

2011-11-01

175

F-18 FDG hypermetabolism in mass-forming focal pancreatitis and old hepatic schistosomiasis with granulomatous inflammation misdiagnosed by PET/CT imaging  

PubMed Central

Purpose: We report the case of a 59-year-old male patient who presented with space-occupying lesions in the pancreas and liver suggestive of metastatic pancreatic cancer. Materials and methods: Whole-body F-18 fluorodeoxyglucose (FDG) PET/CT imaging and enhanced CT imaging of the lesions were performed in addition to abdominal ultrasound, ERCP, and MRCP. Tumor markers, including CA199 and AFP, were also evaluated. Results: PET/CT imaging showed a soft tissue mass with indistinct boundaries in the head of the pancreas with a maximum SUV of 4.39. A less dense shadow was also found in the left lobe of the liver with an indistinct boundary and a maximum SUV of 4.13. Enhanced CT revealed an enhancing mass in the head of the pancreas on arterial phase imaging as well as a mildly enhancing focus in the left lobe of the liver. The patient was diagnosed with a space-occupying lesion of the uncinate process of the pancreas suggestive of pancreatic cancer with metastasis to the liver. However, serum tumor markers were normal. Postoperative pathology was consistent with chronic pancreatitis and old hepatic schistosomiasis associated with granulomatous inflammation of the liver. Conclusion: This case of mass-forming pancreatitis and granulomatous inflammation in old hepatic schistosomiasis mimicked metastatic pancreatic cancer on PET/CT. Such false positive lesions have not been reported before, and further exploration and investigation are needed. PMID:25337288

Ye, Song; Wang, Wei-Lin; Zhao, Kui

2014-01-01

176

Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities  

ERIC Educational Resources Information Center

Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

2013-01-01

177

Complementary use of optical coherence tomography and 5-aminolevulinic acid induced fluorescent spectroscopy for diagnosis of neoplastic processes in cervix and vulva  

Microsoft Academic Search

A new approach to improving the diagnostic value of optical methods is suggested, which is based on a complementary investigation of different optical parameters of biotissues. The aim of this paper is comparative study of the feasibility of two optical methods - fluorescence spectroscopy and optical coherence tomography - for visualization of borders of neoplastic processes in the uterine cervix

Veronika V. Sapozhnikova; Natalia M. Shakhova; Vladislav A. Kamensky; Roman V. Kuranov; Victor B. Loshenov; Svetlana A. Petrova

2003-01-01

178

Human Papillomavirus (HPV) Signs and Symptoms  

MedlinePLUS

... treat. These include cancers of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of ... other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in ...

179

General Information about Vulvar Cancer  

MedlinePLUS

... includes: Inner and outer lips of the vagina . Clitoris (sensitive tissue between the lips). Opening of the ... the vulva. The vulva includes the mons pubis, clitoris, urethral opening, inner and outer lips of the ...

180

Pseudohyperplastic squamous cell carcinoma of the penis associated with lichen sclerosus. An extremely well-differentiated, nonverruciform neoplasm that preferentially affects the foreskin and is frequently misdiagnosed: a report of 10 cases of a distinctive clinicopathologic entity.  

PubMed

We present 10 cases of well-differentiated, squamous cell carcinoma of the penis with pseudohyperplastic features. At presentation, the median age was 69 years. Seven of the tumors were multicentric, and the majority preferentially involved the foreskin inner mucosal surface. Grossly the tumors were typically flat or slightly elevated, white and granular, and measured approximately 2 cm. Characteristic histologic features included keratinizing nests of squamous cells with minimal atypia surrounded by a reactive fibrous stroma. In biopsies or individual areas of resected specimens, the differential diagnosis with pseudoepitheliomatous hyperplasia was difficult but when samples of adequate size were available, obvious evidence of infiltration was present. The adjacent squamous epithelium typically showed changes that are known to be associated with squamous cell carcinoma ranging from squamous hyperplasia to low-grade, and in a few cases high-grade, squamous intraepithelial lesions. Well-developed lichen sclerosus was seen in all cases. Patients were treated by circumcision or partial penectomy. With the exception of 1 patient who developed a glans recurrence 2 years after initial circumcision, follow-up after the initial surgical procedure has been uneventful. The majority of penile carcinomas with the high degree of differentiation seen in these cases are in the category of the verruciform tumors, either the verrucous or papillary carcinoma, not otherwise-specified subtypes. Experience with the cases reported in this series indicates that a subset of nonverruciform, often multicentric, tumors with a high degree of differentiation and pseudohyperplastic features occur and preferentially involve the foreskin. Because it was present in all cases, lichen sclerosus may play a precancerous role. PMID:15223959

Cubilla, Antonio L; Velazquez, Elsa F; Young, Robert H

2004-07-01

181

Wnt and EGF pathways act together to induce C. elegans male hook development  

E-print Network

Comparative studies of vulva development between Caenorhabditis elegans and other nematode species have provided some insight into the evolution of patterning networks. However, molecular genetic details are available ...

Sternberg, Paul W.

182

Molecular characterization of a Spirometra mansoni antigenic polypeptide gene encoding a 28.7 kDa protein.  

PubMed

The Spirometra mansoni antigenic polypeptide (SmAP) gene was expressed in Escherichia coli, and its characteristics and value as an antigen for the serodiagnosis of sparganosis were investigated. The recombinant SmAP protein (rSmAP) has the molecular weight of 28.7 kDa. On Western blotting analysis, the rSmAP strongly reacted with the sera of mice infected with spargana, but not with normal sera; the anti-rSmAP serum obviously recognized the 28.7-kDa band in the crude antigens and excretory-secretory (ES) antigens of spargana. The immunofluorescence test (IFT) results showed that the positive staining was observed at different stages of spargana from the infected frogs and mice, but not adult worm of S. mansoni. An immunolocalization analysis identified SmAP in the teguments and parenchymal tissues of spargana. ELISA with rSmAP antigen or sparganum ES antigens were evaluated for the serodiagnosis of sparganosis. The results showed that the sensitivity of rSmAP-ELISA and ES-ELISA was 83.3% (25/30) and 100% (30/30), respectively, for the detection of anti-sparganum IgG antibodies in sera of the experimentally infected mice (P?>?0.05), the specificities of both ELISA were 100% (67/67). It is suggested that the rSmAP might be a potential candidate antigen for serodiagnosis of sparganosis. PMID:25096536

Cui, Jing; Wei, Tong; Liu, Li Na; Zhang, Xi; Qi, Xin; Zhang, Zi Fang; Wang, Zhong Quan

2014-09-01

183

An Unusual Gross Appearance of Vulval Tuberculosis Masquerading as Tumor  

PubMed Central

Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized. PMID:25298898

Arakeri, Surekha U.

2014-01-01

184

Genital HPV Infection  

MedlinePLUS

... STDs) Share Compartir Genital HPV Infection - Fact Sheet Human papillomavirus (HPV) is the most common sexually transmitted ... other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in ...

185

Vulvodynia  

MedlinePLUS

... nerve endings in the vestibule • Increased production of chemicals by cells in the vulva that lead to inflammation • Long-term reactions to certain infections • Changes in responses to hormones • ...

186

Cysteine Dioxygenase 1 Is a Tumor Suppressor Gene Silenced by Promoter Methylation in Multiple Human Cancers  

E-print Network

cancers (breast, kidney, rectum, colon, stomach, skin, thyroid,thyroid, skin, kidney, bladder, lung, breast, ovary, uterus, cervix and vulva cancer.cancer. a Down Up b Colon Stomach Rectum Small Intestine Pancreas Liver c c Thyroid

2012-01-01

187

Vulvar Care  

MedlinePLUS

... A make up remover that contains mineral oil, petroleum jelly, and paraffi n also can be used ( ... washcloth and put it against your vulva. Refrigerated petroleum jelly (Vaseline) and cold plain yogurt put on ...

188

Vaginal itching and discharge - Adult and adolescent  

MedlinePLUS

Vaginal discharge refers to secretions from the vagina . The discharge may be: Thick, pasty, or thin Clear, cloudy, bloody, ... area (vulva) may be present along with vaginal discharge. It can also occur on its own.

189

What's New in Vulvar Cancer Research and Treatment?  

MedlinePLUS

... the vulva. There are some promising new developments. Oncogenes and tumor suppressor genes Scientists are learning more about how certain genes called oncogenes and tumor suppressor genes control cell growth and ...

190

Prevent Cervical Cancer  

MedlinePLUS

... AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-839KB] High-quality PDF ... cervix, uterus, vagina, and vulva. Stay Informed Printable Versions Standard quality PDF [PDF-839KB] High-quality PDF ...

191

21 CFR 884.5390 - Perineal heater.  

...the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the vulvar orifice for obstetrical purposes). (b) Classification. Class II (performance...

2014-04-01

192

Gumma  

MedlinePLUS

... 59(RR-12):1-110. Eckert LO, Lentz GM. Infections of the lower genital tract: Vulva, vagina, ... shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ...

193

Genital sores - female  

MedlinePLUS

... DC. Neoplastic diseases of the vulva. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds . Comprehensive ... Mosby Elsevier; 2012:chap 30. Eckert L, Lentz GM. Infections of the lower genital tract. In: Lentz ...

194

Bartholin cyst or abscess  

MedlinePLUS

... Saunders Elsevier; 2013:chap 37. Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, ... toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

195

Bleomycin  

MedlinePLUS

... throat, tonsils, and sinuses) and cancer of the penis, testicles, cervix, and vulva (the outer part of ... IMPORTANT WARNING section, call your doctor immediately: sudden numbness or weakness of face, arm, or leg on ...

196

20 CFR 25.101 - How is compensation for disability paid?  

Code of Federal Regulations, 2012 CFR

...compensation. (20) Tongue lost: 160 weeks' compensation. (21) Ovary (one) lost: 52 weeks' compensation. (22) Uterus/cervix and vulva/vagina lost: 205 weeks' compensation. (23) Skin: 205 weeks' compensation. (24)...

2012-04-01

197

20 CFR 10.404 - When and how is compensation for a schedule impairment paid?  

Code of Federal Regulations, 2010 CFR

...one) 156 Larynx 160 Lung (one) 156 Penis 205 Testicle (one) 52 Tongue 160 Ovary (one) 52 Uterus/cervix and vulva/vagina 205 (b) Compensation for schedule awards is payable at 662/3 percent of the...

2010-04-01

198

elife.elifesciences.org VijayRaghavan and Rath. eLife 2013;2:e00729. DOI: 10.7554/eLife.00729 1 of 3  

E-print Network

, the fallopian tubes, which convey eggs from the ovaries to the uterus, decreases the incidence of ovarian cancer, before moving on to the uterus and finally being deposited from the vulva (Figure 1; Middleton et al

199

20 CFR 10.404 - When and how is compensation for a schedule impairment paid?  

Code of Federal Regulations, 2011 CFR

...one) 156 Larynx 160 Lung (one) 156 Penis 205 Testicle (one) 52 Tongue 160 Ovary (one) 52 Uterus/cervix and vulva/vagina 205 (b) Compensation for schedule awards is payable at 662/3 percent of the...

2011-04-01

200

20 CFR 10.404 - When and how is compensation for a schedule impairment paid?  

...one) 156 Larynx 160 Lung (one) 156 Penis 205 Testicle (one) 52 Tongue 160 Ovary (one) 52 Uterus/cervix and vulva/vagina 205 Skin 205 (c) Compensation for schedule awards is payable at 662/3 percent...

2014-04-01

201

20 CFR 10.404 - When and how is compensation for a schedule impairment paid?  

Code of Federal Regulations, 2012 CFR

...one) 156 Larynx 160 Lung (one) 156 Penis 205 Testicle (one) 52 Tongue 160 Ovary (one) 52 Uterus/cervix and vulva/vagina 205 Skin 205 (c) Compensation for schedule awards is payable at 662/3 percent...

2012-04-01

202

20 CFR 10.404 - When and how is compensation for a schedule impairment paid?  

Code of Federal Regulations, 2013 CFR

...one) 156 Larynx 160 Lung (one) 156 Penis 205 Testicle (one) 52 Tongue 160 Ovary (one) 52 Uterus/cervix and vulva/vagina 205 Skin 205 (c) Compensation for schedule awards is payable at 662/3 percent...

2013-04-01

203

The simplicity of the Ovulation Method and its application in various circumstances.  

PubMed

The ovulation method is considered as an advancement over other natural family planning methods. The strengths are in the identification of preovulatory infertility, and the peak which indicates ovulatory fertility and postovulatory fertility. Cervical mucus identification, which is described, is a secure method of insuring the effectiveness of the Billings Ovulation Methods when fertility returns during or after breast feeding and delayed ovulation due to stress. Charting should begin immediately regardless of whether one is breast feeding or not. Daily records provide information on the sensation of the vulva and the appearance of the mucus: a green stamp for a dry vulva and no mucus; a yellow stamp for slight, cloudy discharge that remains the same and dry vulva; a white baby stamp for a wet vulva and fluid mucus; an X for peak fertility or ovulation on the last day of fluid mucus to a change for 3 days of thick sticky mucus; and a red stamp for menstruation which begins 11-22 days after the peak. The basic infertile period is characterized by either no mucus or vulval dryness or an unchanging discharge at the vulva which accompanies a low unchanging estrogen level, or a combination of the preceding 2 conditions. Except for the first case of vulva dryness, the patterns of discharge originate in the vagina. Possible fertility is signified by rising estrogen levels which cause a cervical response. Changing levels of estrogen also produce endometrial responses of breakthrough or withdrawal bleeding. Fertility continues until menopause. PMID:1746205

Billings, E L

1991-01-01

204

Tracheal stenosis mimicking severe acute asthma  

PubMed Central

Post-intubation tracheal stenosis is a rare but serious clinical entity that rarely develops when intubation is less than a week. These patients may remain asymptomatic for a variable period and are often misdiagnosed as asthmatic. The authors report a case of a middle-aged lady who was initially misdiagnosed as having acute asthma after brief tracheal intubation. PMID:22789696

Zubairi, Ali Bin Sarwar; Dildar, Babar; Husain, Shahid Javed; Khan, Mohammad Faisal

2010-01-01

205

Tracheal stenosis mimicking severe acute asthma.  

PubMed

Post-intubation tracheal stenosis is a rare but serious clinical entity that rarely develops when intubation is less than a week. These patients may remain asymptomatic for a variable period and are often misdiagnosed as asthmatic. The authors report a case of a middle-aged lady who was initially misdiagnosed as having acute asthma after brief tracheal intubation. PMID:22789696

Zubairi, Ali Bin Sarwar; Dildar, Babar; Husain, Shahid Javed; Khan, Mohammad Faisal

2010-01-01

206

Neuroparasitic Infections: Cestodes, Trematodes, and Protozoans  

PubMed Central

Parasitic infection of the nervous system can produce a variety of symptoms and signs. Because symptoms of infection are often mild or nonspecific, diagnosis can be difficult. Familiarity with basic epidemiological characteristics and distinguishing radiographic findings can increase the likelihood of detection and proper treatment of parasitic infection of the nervous system. This article discusses the clinical presentation, diagnosis, and treatment for some of the more common infections of the nervous system caused by cestodes, trematodes and protozoans: Echinococcus spp., Spirometra spp. (sparganosis), Paragonimus spp., Schistosoma spp., Trypanosoma spp., Naegleria fowlerii, Acanthamoeba histolytica, and Balamuthia mandrillaris. PMID:16170739

Walker, M.D.; Zunt, J.R.

2009-01-01

207

Spirometra (Pseudophyllidea, Diphyllobothriidae) Severely Infecting Wild-Caught Snakes from Food Markets in Guangzhou and Shenzhen, Guangdong, China: Implications for Public Health  

PubMed Central

Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January–August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0?96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans. PMID:24558340

Gong, Shiping

2014-01-01

208

Pentastomiasis and other parasitic zoonoses from reptiles and amphibians.  

PubMed

Reptiles are growing in popularity as pets.The colonization of reptiles and amphibians by parasites and the resulting disease conditions are the most common problems seen in captive animals.This review focuses on pentastomiasis and sparganosis, important parasitic zoonoses of reptiles and amphibians, respectively, and free living-amoebae. Humans are suitable accidental hosts for some pentastomid species (particularly Armillifer and Porocephalus). In geographical areas with special ethnics, such as in West and Central Africa, and East Asia, 8-45% of the human population can be affected. Usually the larvae are coincidentally found during abdominal surgeries. However, fatalities have been described. Extreme caution is necessary when handling infected reptiles. Ocular or cerebral sparganosis is not uncommonly found in humans in East Asia. This disease is caused by spargana, tapeworm larvae (plerocercoids) of Spirometra sp. The infection occurs when uncooked meat from reptiles or amphibians is applied to wounds or eyes and the parasites migrate directly to human tissue, or by consumption of contaminated food or water. As a consequence of the reptile's predatory behaviour, the full spectrum of endo- and ectoparasites from potential prey animals can be found as transiting parasites in the intestinal tract, e. g. Hymenolepis nana, Cryptosporidium (C.) muris, C parvum or Capillaria hepatica. Occasionally, free-living amoebae are also found in reptile faeces (Acanthamoeba, Naegleria, Hartmanella, Vahlkampfia or Echinamoeba sp.). PMID:22191176

Pantchev, Nikola; Tappe, Dennis

2011-01-01

209

Comparison of molecular abnormalities in vulvar and vaginal melanomas.  

PubMed

Malignant melanoma of the vulva and vagina is relatively uncommon and accounts for <5% of all melanomas in women. The aim of our study was to establish the biological properties and evaluate potential therapeutic targets in these tumors. We collected a series of 65 cases from three centers and re-evaluated the tumor tissue for predominant growth pattern (superficial spreading, nodular, and mucosal lentiginous) and tumor thickness. KIT (CD117) expression was detected immunohistochemically. In addition, tumors were screened for BRAF, NRAS, and KIT mutations by PCR and DNA sequencing as well as for KIT amplifications by fluorescence in situ hybridization. None of the cases contained BRAF mutations. NRAS mutations and KIT amplifications were detected in similar frequency (?12%) in tumors of the vulva and vagina. In contrast, KIT mutations were present in 18% of primary melanomas of the vulva, but in none of the tumors arising in the vagina. Moderate or strong KIT protein expression was detected in 30 cases, including all tumors with KIT mutations and 6 of the 7 with KIT amplifications. In conclusion, BRAF mutations are virtually absent in melanomas originating from the vulva or vagina, whereas NRAS mutations and KIT amplifications occur in both locations. KIT mutations appear to be specific for melanomas of the vulva, suggesting that in spite of the anatomic proximity, the development of vulvar and vaginal melanomas involves different molecular alterations which may be targeted by novel treatment approaches. PMID:24603591

Aulmann, Sebastian; Sinn, Hans P; Penzel, Roland; Gilks, C Blake; Schott, Sarah; Hassel, Jessica C; Schmidt, Dietmar; Kommoss, Friedrich; Schirmacher, Peter; Kommoss, Stefan

2014-10-01

210

Vulvar disorders in the prepubertal female.  

PubMed

Inspection of the vulva should be a routine part of well child care. Detection of poor perineal hygiene permits the establishment of good hygiene practices, which may prevent development of vulvovaginitis. Condylomata acuminata, molluscum contagiosum, herpetic vulvitis, and vulvovaginitis secondary to Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamydia trachomatis, and Trichomonas vaginalis arouse suspicion of child sexual abuse, which must be addressed. Atopic dermatitis, psoriasis, lichen planus, and lichen sclerosis et atrophicus are often chronic and early diagnosis with appropriate treatment and follow-up contributes to the acceptance of the disease by parent and child. Early detection of the rare neoplasms of the vulva is essential to improved survival. PMID:3529014

Williams, T S; Callen, J P; Owen, L G

1986-08-01

211

CADASIL  

MedlinePLUS

... arteries. CADASIL is characterized by migraine headaches and multiple strokes progressing to dementia. Other symptoms include cognitive ... available before 2000, many cases were misdiagnosed as multiple sclerosis, Alzheimer's disease, or other neurodegenerative diseases. Is ...

212

Quit Obsessing!  

ERIC Educational Resources Information Center

Asserts the obsessive-compulsive disorder is often misdiagnosed in children and adolescents; describes characteristics of obsessive-compulsive disorder; differentiates between normal and abnormal obsessions; suggests ways teachers can help students diagnosed with the disorder. (PKP)

Schlozman, Steven C.

2002-01-01

213

75 FR 28621 - Proposed Data Collections Submitted for Public Comment and Recommendations  

Federal Register 2010, 2011, 2012, 2013

...gender, and family history) associated with the disease; and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

2010-05-21

214

75 FR 4568 - Agency Forms Undergoing Paperwork Reduction Act Review  

Federal Register 2010, 2011, 2012, 2013

...diagnosed with the disease) associated with the disease; and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

2010-01-28

215

75 FR 69086 - Agency Forms Undergoing Paperwork Reduction Act Review  

Federal Register 2010, 2011, 2012, 2013

...family history of individuals diagnosed with the disease); and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

2010-11-10

216

Genetics Home Reference: Ethylmalonic encephalopathy  

MedlinePLUS

... have been misdiagnosed as other neurologic disorders. What genes are related to ethylmalonic encephalopathy? Mutations in the ETHE1 gene cause ethylmalonic encephalopathy. The ETHE1 gene provides instructions ...

217

Etiology of voiding dysfunction in men less than 50 years of age  

Microsoft Academic Search

ObjectivesChronic lower urinary tract symptoms in young men are often attributed to misdiagnosed chronic nonbacterial prostatitis. The purpose of this study was to analyze etiology of chronic voiding dysfunction in men less than 50 years of age.

Steven A. Kaplan; Edward F. Ikeguchi; Richard P. Santarosa; Patricia Meade D'alisera; James Hendricks; Alexis E. Te; Mark I. Miller

1996-01-01

218

Noname manuscript No. (will be inserted by the editor)  

E-print Network

to a taxonomic problem involving species of suckers in the genus Carpiodes. The results confirm the necessity have traditionally been misdiagnosed as C. carpio but are in fact more close to C. cyprinus. We also

Chen, Yixin

219

New and described species of nematodes from shorebirds (Charadriiformes) collected in spring in Iceland  

Microsoft Academic Search

The following were found in shorebirds collected during late April and early May shortly after their arrival in Iceland. Voguracuaria lankesteri n. g., n. sp. was found in the oesophagus of eight of 20 whimbrels Numenius p. phaeopus. The new genus resembles Syncuaria, but males have an area rugosa and small caudal alae, females are didelphic and the vulva is

P. L. Wong; R. C. Anderson

1993-01-01

220

Cancer of the Cervix  

MedlinePLUS

... is human papillomavirus (HPV) infection (see the FAQ Human Papillomavirus [HPV] Infection). There are many types of HPV. Some types of HPV, called “high-risk types,” can cause cancer of the anus, cervix, vulva, vagina, and penis. They also can cause cancer of the head ...

221

Protocylindrocorpus dendrophilus n. sp. (Nematoda: Cylindrocorpidae) Associated with Pine Wood Borings  

PubMed Central

Protocylindrocorpus dendrophilus n. sp. is described from xylem samples taken from beetle infested slash pine (Pinus elliottii Engelmann var. elliottii) in Central Louisiana. It is similar to P. goodeyi (Rühm) Paramonov, but differs by the possession of a protuberant and more posteriorly located vulva and in the position of the caudal papillae. Morphometrics of the male and female are presented. PMID:19295889

Kinn, D. N.

1984-01-01

222

Clemson University Cooperative Extension Service Dr. Dan B. Smith, Director  

E-print Network

with DHEC Vesicular Stomatitis Hog Cholera Cattle Tick Fever Foot and Mouth Disease Vesicular Exanthema by foot, udder, vulva or skin lesions (Blisters-Vesicles) Ex: Foot & Mouth Vesicular Stomatitis, etc. 2 these conditions. Reportable Disease in SC by Clinical Symptoms 1. Sore Mouth-Muzzle: especially if accompanied

Bolding, M. Chad

223

Moniliformin produced by cultures of Fusarium moniliforme var. subglutinans isolated from swine feed  

Microsoft Academic Search

Feed samples from Iowa suspected of causing vomiting and enlarged vulva as well as mortalities of swine were examined for toxigenic fungi and mycotoxins Fusarium moniliforme Sheldon and F. moniliforme Sheldon var. subglutinans Wollenew. & Reink. accounted for 43% and 18.5%, respectively, of the total count of 4.75×105 propagules filamentous fungi per gram of swine feed, but representatives of various

R. F. Vesonder

1986-01-01

224

University of Montana Office of Public Safety/Police Sexual  

E-print Network

University of Montana Office of Public Safety/Police Sexual Assault Investigation Policy Effective of Montana Office of Public Safety/Police Sexual Assault Investigation Policy Page | 1 I. PURPOSE The purpose · Penetration of the vulva, anus, or mouth by the penis of another person #12;University of Montana Office

Chu, Xi

225

Female pseudo-hermaphroditism with cloacal malformation and related anomalies in a dog.  

PubMed

A 7-month-old intact female German shepherd dog was presented with recurrent urinary tract infections and incontinence, ambiguous external genitalia (enlarged vulva containing a penis), and an anovestibular fistula. Anatomical structures, histopathology, and karyotyping supported a diagnosis of female pseudo-hermaphrodite, hypothesized to be a result of in utero androgenization with consequential cloacal malformation. PMID:23543931

Sacks, Margot K; Béraud, Romain

2012-10-01

226

Urogenital tumors  

SciTech Connect

An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

Weller, R.E.

1994-03-01

227

AIFsh, a Novel AIF Proapoptotic Isoform with Potential Pathological Relevance in Human Cancer  

E-print Network

in tumor cells derived from kidney, vulva, skin, thyroid and pancreas, whereas, -irradiation treatment and shed new light on the role of caspase-independent cell death in tumor formation/suppression. Apoptosis of apoptosis play an essential role in tumor development (3,4). The elucidation of the apoptotic pathways

Paris-Sud XI, Université de

228

Evaluation of the Role of Vibrational Spectroscopy in the Assessment of Vulval Disease  

ClinicalTrials.gov

Normal Vulval Skin; Lichen Sclerosus; High Grade Dysplasia - Usual Type ('VIN 2-3'); High Grade Dysplasia - Differentiated Type ('VIN 2-3'); Squamous Cell Carcinoma; Epithelial Hyperplasia Without Atypia; Atypia Not Otherwise Specified/ Low Grade Dysplasia ('VIN 1'); Pagets Disease of the Vulva

2014-08-21

229

Description of Meloidoderita polygoni n. sp. (Nematoda: Meloidoderitidae) from USA and Observations on M. kirjanovae from Israel and USSR 1  

Microsoft Academic Search

Meloidoderita polygoni n. sp. is described and illustrated from roots of smartweed (Polygonum hydropiperoides) from Beltsville, Maryland. This new species is similar to M. kirjanovae but differs especially in having larger spines on the cystoid bodies, females with the anus much closer to the vulva, and more posterior excretory pore. M. polygoni differs from M. safrica particularly in having females

A. MORGAN GOLDEN; ZAFAR A. HANDOO

1984-01-01

230

Characterization of a New Species of Cyst Nematode Parasitizing Corn  

Technology Transfer Automated Retrieval System (TEKTRAN)

Examination of soil around unthrifty corn roots in northwestern Tennessee (Obion County) in 2006 revealed high population densities of juvenile nematodes and lemon-shaped cysts. This nematode resembles Cactodera spp. in possessing a circumfenestrate vulva but lacking bullae and an underbridge. These...

231

The anchor cell initiates dorsal lumen formation during C. elegans vulval tubulogenesis.  

PubMed

Tubulogenesis and lumen formation are critical to the development of most organs. We study Caenorhabditis elegans vulval and uterine development to probe the complex mechanisms that mediate these events. Development of the vulva and the ventral uterus is coordinated by the inductive cell-signaling activity of a gonadal cell called the anchor cell (AC). We demonstrate that in addition to its function in specifying fate, the AC directly promotes dorsal vulval tubulogenesis. Two types of mutants with defective anchor cell behavior reveal that anchor cell invasion of the vulva is important for forming the toroidal shape of the dorsal vulval cell, vulF. In fos-1 mutants, where the AC cannot breakdown the basement membranes between the gonad and the vulva, and in mutants in unc-6 netrin or its receptor unc-40, which cause AC migration defects, the AC fails to invade the vulva and no lumen is formed in vulF. By examining GFP markers of dorsal vulval cell fate, we demonstrate that fate specification defects do not account for the aberrant vulF shape. We propose that the presence of the AC in the center of the developing vulF toroid is required for dorsal vulval lumen formation to complete vulval tubulogenesis. PMID:19389356

Estes, Kathleen A; Hanna-Rose, Wendy

2009-04-15

232

www.ext.vt.edu Produced by Communications and Marketing, College of Agriculture and Life Sciences,  

E-print Network

of labor in normal calving: 1. First stage: The first stage of labor is when the cer- vix is dilating is delivered. The amniotic sac, or water bag, will appear at the vulva. The fetus starts to enter the birth birth. It is considered "retained" at 12 to 24 hours, but manually remov- ing the afterbirth

Liskiewicz, Maciej

233

A hypothesis about the origin of sperm storage in the Eubrachyura, the effects of seminal receptacle structure on mating strategies and the evolution of crab diversity: How did a race to be first become a race to be last?  

Microsoft Academic Search

The origins and evolution of sperm storage in Brachyura are enigmatic: sperm is either stored in seminal receptacles, accessible via the vulvae on the sixth thoracic sternite, or in spermathecae at the border between the seventh and eighth sternites. Crabs with spermathecae are collectively referred to as “podotremes” while crabs with seminal receptacles belong to the Eubrachyura. The position of

Colin L. McLay; Laura S. López Greco

2011-01-01

234

Mechanism of Activation of the Caenorhabditis elegans rm Homologue let-60 by a Novel, Temperature-Sensitive, Gain-of-Function Mutation  

Microsoft Academic Search

The Caenorhabditis ekgans kt-60 gene encodes a Ras protein that mediates induction of the hermaphro- dite vulva. To better understand how mutations constitutively activate Ras and cause unregulated cell division, we have characterized ga89, a temperature-sensitive, gain-of-function mutation in let-60 ras. At 25\\

David M. Eisenmann; Stuart K. Kim

1997-01-01

235

INTRODUCTION A central issue in developmental biology is how discrete cells  

E-print Network

; discussed in Li and Chalfie, 1990; Thomas et al., 1990). Eggs are stored in the mesodermal uterus, once formed, the vulva connects properly to the uterus. A signal from the uterine anchor cell (AC that attach the uterus to the lateral epidermis (seam) on each side of the animal, connected by a thin planar

Horvitz, H. Robert

236

Purdue extensionPurdue extension AS-561-WAS-561-W  

E-print Network

is the cervix. The cervix is the barrier between the vagina and the uterus. It serves to protect the more delicate and highly vascularized uterus from invasion by foreign uterine horns uterus cervix vagina vulva · Knowledge to Go objects, and is also a tight seal that keeps the uterus closed during pregnancy. The uterus

237

Laser versus Loop Electrosurgical Excision in Vulvar Condyloma for Eradication of Subclinical Reservoir Demonstrated by Assay for 2’-5’Oligosynthetase Human Papillomavirus  

Microsoft Academic Search

We studied, in an open clinical trial, 28 women with giant solitary human papillomavirus (HPV) lesions of the vulva that were treated by both laser and the loop electrosurgical excision procedure (LEEP), and analyzed the biopsy specimens of normal skin adjacent to the lesions for papillomavirus sequencs by Southern blot hybridization and 2’-5’ oligo-A synthetase (interferon) activity. The patients were

A. Schoenfeld; E. Ziv; H. Levavi; Z. Samra; J. Ovadia

1995-01-01

238

Epidemiology of Human Papillomavirus Infection in Men, Cancers other than Cervical and Benign Conditions  

Microsoft Academic Search

Human papillomavirus (HPV) infection is commonly found in the genital tract of men and women with or without any clinical lesion. The association of HPV DNA with several different ano-genital cancers other than cervical has been reported for the vulva, vagina, anus and penis. HPV DNA has also been identified in head and neck cancers in the oral cavity, the

Anna R. Giuliano; Guillermo Tortolero-Luna; Elena Ferrer; Ann N. Burchell; Silvia de Sanjose; Susanne Kruger Kjaer; Nubia Muñoz; Mark Schiffman; F. Xavier Bosch

2008-01-01

239

Eosinophilic Pleuritis due to Sparganum: A Case Report  

PubMed Central

Sparganosis is a rare parasitic disease caused by migrating plerocercoid tapeworm larva of the genus Spirometra. Infection in humans is mainly caused by the ingestion of raw or inadequately cooked flesh of infected frogs, snakes, and chickens. Here, we report a rare case of a 45-year-old man who was admitted to our hospital with left lower chest pain. The chest radiograph and computed tomography (CT) scan revealed localized pleural effusion in the left lower lobe; further, peripheral blood eosinophilia and eosinophilic pleural effusion were present. Percutaneous catheter drainage was performed, which revealed long worm-shaped material that was identified as a sparganum by DNA sequencing. The patient showed clinical improvement after drainage of the sparganum. This study demonstrates the importance of considering parasitic diseases in the differential diagnosis of eosinophilic pleural effusion. PMID:25352705

Oh, Youngmin; Kim, Jeong-Tae; Kim, Mi-Kyeong; Chang, You-Jin; Eom, Keeseon; Park, Jung-Gi; Lee, Ki-Man; Choe, Kang-Hyeon

2014-01-01

240

Immunodiagnosis of alveolar echinococcosis by enzyme-linked immunosorbent assay using a partially purified Em18/16 enriched fraction.  

PubMed

An improved enzyme-linked immunosorbent assay (ELISA) system using partially purified Eml8/16 enriched fraction (PP-Em18/16) prepared by isoelectric focusing was evaluated for serodiagnosis of alveolar echinococcosis (AE). The PP-Em18/16-ELISA was compared with Em2plus-ELISA by using sera from AE and cystic echinococcosis (CE) patients in China, where both AE and CE are endemic; sera from CE patients in Australia, where only CE exists; and sera from patients with cysticercosis, paragonimiasis, or sparganosis in Korea, where no indigenous AE or CE exists. We used Em2plus-ELISA as a standard ELISA and found 24.6% (17 of 69 specimens) cross-reactivity with sera from CE. Furthermore, some of the sera from paragonimiasis, sparganosis, and cysticercosis patients were also cross-reactive in the Em2plus-ELISA. When we tested for similar cross-reactivity in the same sera from CE patients by PP-Em18/16-ELISA (23.2%, 16 of 69), it became evident that the specificity of the PP-Em18/16-ELISA was better than that of the Em2plus-ELISA, since no sera from patients with the examined parasitic diseases except CE showed cross-reactivity. Some CE patients from China showed exceptionally high levels of antibody in comparison with those of CE patients from Australia, where no AE occurs. It is speculated that these patients with strongly positive cases of CE from China may have been exposed to both species of Echinococcus. PMID:9008281

Ito, A; Ma, L; Itoh, M; Cho, S Y; Kong, Y; Kang, S Y; Horii, T; Pang, X L; Okamoto, M; Yamashita, T; Lightowlers, M W; Wang, X G; Liu, Y H

1997-01-01

241

Spinal Neurofibroma Masquerading as a Herniated Disc  

PubMed Central

We present the only case in English medical literature of a spinal neurofibroma misdiagnosed as a herniated disc using magnetic resonance imaging (MRI). This case presented with typical symptoms and radiological findings of a herniated disc. Intraoperatively, an abnormality was noted at the S1 nerve root sleeve. Further exploration revealed a spinal neurofibroma which was completely resected, resulting in an improvement in the patient’s symptoms. Currently, there is heavy reliance on MRI as a highly sensitive and specific tool used in the diagnosis of herniated lumbar discs. Although there have been occasional reports of misdiagnoses using MRI, there are no reported cases of a spinal neurofibroma being misdiagnosed as a herniated lumbar disc. Despite great advances in radiological diagnostic imaging, surgical surprises do still occur. Ultimately, instinct is still essential in intraoperative surgical decisions. PMID:23275853

Lamki, Tariq; Ammirati, Mario

2012-01-01

242

[Might it be epilepsy? What should the genera;l practitioner look out for in differential diagnosis].  

PubMed

Both a missed diagnosis of epilepsy, a wrong diagnosis of epilepsy as something else, and a misdiagnosis of something else as epilepsy can have serious consequences for the patient, e.g. therapeutic deviations, or physical, physical and social complications. Not all possible but some important problems of differential diagnosis are discussed, including both typical misdiagnoses of epileptic seizures as cardiac synkope or pseudoepileptic fits, oversight of subtle manifestions of epilepsy such as absences, juvenile myoclonic epilepsy, and isolated auras, and misdiagnoses as epilepsy of migraine variants, syncope, episodic ataxias, narcolepsy, and parasomnias. PMID:14579477

Wolf, P

2003-05-26

243

Cervicofacial actinomycosis mimicking sebaceous cyst  

PubMed Central

Actinomycosis is a rare, torpid, suppurative and chronic granulomatous infection caused by a Gram-positive organism that was initially thought to be a fungus. These organisms normally live as commensals in the human oral cavity, respiratory and digestive tracts, but become invasive when they gain access to the subcutaneous tissue through a musosal lesion, the triggering events being dental caries, dental manipulation and maxillofacial trauma. It is often misdiagnosed as it can mimic numerous infectious and non-infectious diseases. We describe an interesting case of cervical actinomycosis that was misdiagnosed as sebaceous cyst and precisely identified after histopathological examination of the tissue. PMID:23417945

Jain, Anshu; Narula, Varsha; Alam, Kiran; Shukla, Indu

2013-01-01

244

Morphological Variation in Xiphinema spp. from New York Orchards  

PubMed Central

Xiphinema specimens were collected from orchards in southeastern, northeastern, and western New York. Total length, distance of vulva from anterior end, spear length (odontostyle plus odontophore), body diameter at vulva, tail length, anal body diameter, and length and diameter of hyaline tail tip were measured on fixed, glycerol-infiltrated adult females. Most specimens were identified as X. americanum or X. rivesi, but one western New York population was identified as X. californicum (a new record for New York). Multivariate analyses indicated that, with one exception, western New York populations of both X. americanum and X. rivesi were smaller and slimmer than their eastern counterparts. Regional differences were generally larger than differences attributed to host species. PMID:19290184

Georgi, Laura L.

1988-01-01

245

Morphological Variation in Xiphinema spp. from New York Orchards.  

PubMed

Xiphinema specimens were collected from orchards in southeastern, northeastern, and western New York. Total length, distance of vulva from anterior end, spear length (odontostyle plus odontophore), body diameter at vulva, tail length, anal body diameter, and length and diameter of hyaline tail tip were measured on fixed, glycerol-infiltrated adult females. Most specimens were identified as X. americanum or X. rivesi, but one western New York population was identified as X. californicum (a new record for New York). Multivariate analyses indicated that, with one exception, western New York populations of both X. americanum and X. rivesi were smaller and slimmer than their eastern counterparts. Regional differences were generally larger than differences attributed to host species. PMID:19290184

Georgi, L L

1988-01-01

246

New Species of Cyst Nematode Heterodera pakistanensis (Nematoda: Heteroderidae) Attacking Wheat in Pakistan  

PubMed Central

Heterodera pakistanensis n. sp., described and illustrated from roots of common wheat (Triticum aestivum) from Sukkur, Sind, Pakistan, belongs to the goettingiana group. It is most closely related to H. cyperi Golden, Rau &Cobb, 1962, H. raskii Basnet & Jayaprakash, 1984, and H. mothi Khan &Husain, 1965. Second-stage juveniles (J2) can be distinguished from H. cyperi J2 by an areolated lateral field with four incisures and shorter stylet, whereas cysts are separated by a more elongated vulva slit and the conspicuous structure of the underbridge. It differs from H. raskii by having four areolated lateral lines in J2, smaller female lemon-shaped cyst, shorter fenestra length and width, conspicuous underbridge, and distinct anus with a high cuticular pattern 40-45 ?m from posterior end. It also differs from H. mothi by the presence of four areolated lateral lines in J2 and absence of vulva denticles and bullae. PMID:19294224

Maqbool, M. A.; Shahina, F.

1986-01-01

247

New Species of Cyst Nematode Heterodera pakistanensis (Nematoda: Heteroderidae) Attacking Wheat in Pakistan.  

PubMed

Heterodera pakistanensis n. sp., described and illustrated from roots of common wheat (Triticum aestivum) from Sukkur, Sind, Pakistan, belongs to the goettingiana group. It is most closely related to H. cyperi Golden, Rau &Cobb, 1962, H. raskii Basnet & Jayaprakash, 1984, and H. mothi Khan &Husain, 1965. Second-stage juveniles (J2) can be distinguished from H. cyperi J2 by an areolated lateral field with four incisures and shorter stylet, whereas cysts are separated by a more elongated vulva slit and the conspicuous structure of the underbridge. It differs from H. raskii by having four areolated lateral lines in J2, smaller female lemon-shaped cyst, shorter fenestra length and width, conspicuous underbridge, and distinct anus with a high cuticular pattern 40-45 mum from posterior end. It also differs from H. mothi by the presence of four areolated lateral lines in J2 and absence of vulva denticles and bullae. PMID:19294224

Maqbool, M A; Shahina, F

1986-10-01

248

A rare primary immunodeficiency.  

PubMed

A 9-year-old girl presented with failure to thrive, chronic mucopurulent nasal discharge, recurrent skin pustules and recurrent episodes of purulent ear discharge since 2?years of age. She had coarse facial features with extensive eczema, multiple pyoderma scars, florid dental caries, retained primary dentition, hypermobile joints and a woody induration of the vulva. Autosomal dominant hyper-IgE syndrome was suspected and confirmed by very high serum IgE levels. Vulval biopsy revealed a premalignant condition. STAT 3 mutation, which is usually responsible for this condition, was not found in our case, indicating an as yet unidentified mutation. The child also had unusual features like the total absence of clinical and radiological features of pneumonia. The premalignant change in the vulva was also unusual since vulval carcinoma has not been reported so far in children with this disorder. This child will require a close follow-up to look for malignant transformation. PMID:25253482

Nagaraj, Poornima; Sivathanu, Shobhana; Sampath, Sowmya; Ramakrishnan, Nithiyanantham

2014-01-01

249

In vivo detection of cytokeratin filament network breakdown in cells treated with the phosphatase inhibitor okadaic acid  

Microsoft Academic Search

We have previously described vulva carcinoma-derived A-431 subclone AK13-1, which stably expresses fluorescently labeled cytokeratin filaments (CKFs). Time-lapse fluorescence microscopy of these cells permits the continuous monitoring of the dynamics of the CKF cytoskeleton in vivo. To study mechanisms and principles of CKF disassembly as it occurs, e.g., during mitosis and liver disease, we have treated cells with the phosphatase

Pavel Strnad; Reinhard Windoffer; Rudolf E. Leube

2001-01-01

250

Management of Extramammary Paget's Disease: A Case Report and Review of the Literature  

PubMed Central

Extramammary Paget's Disease (EMPD) is a rare condition of the skin that often involves the vulva, perianal region, scrotum, penis, and axilla. Although prognosis is generally favorable, it can be associated with neoplasms of the bladder, urethra, prostate, and rectum. This report presents a case of scrotal EMPD that failed treatment with imiquimod 5% cream and discusses benefits and complications of available treatment options. The variation of treatment success emphasizes the importance of further research. PMID:24349803

2013-01-01

251

Tissue-Specific Regulation of the LIM Homeobox Gene lin-11 during Development of the Caenorhabditis elegans Egg-Laying System  

Microsoft Academic Search

The egg-laying system of Caenorhabditis elegans hermaphrodites requires development of the vulva and its precise connection with the uterus. This process is regulated by LET-23-mediated epidermal growth factor signaling and LIN-12-mediated lateral signaling pathways. Among the nuclear factors that act downstream of these pathways, the LIM homeobox gene lin-11 plays a major role. lin-11 mutant animals are egg-laying defective because

Bhagwati P. Gupta; Paul W. Sternberg

2002-01-01

252

18F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis  

PubMed Central

Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, 18F-fluoroseoxyglucose positron emission tomography/computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses. PMID:19885320

An, Young-Sil

2009-01-01

253

ARTICLES Clonal History of Papillomavirus-Induced Dysplasia in the Female Lower Genital Tract  

Microsoft Academic Search

Background: Dysplastic lesions of the vagina or the vulva often occur in women who have a previous history of cervical dysplasia. Most lesions in the female lower genital tract are induced by infections with high-risk oncogenic human papil- lomaviruses (HR-HPVs), including HPV16 and HPV18. HR-HPV genomes frequently integrate into host cell chromo- somes at random sites. We analyzed viral integration

Svetlana Vinokurova; Nicolas Wentzensen; Jens Einenkel; Ruediger Klaes; Corina Ziegert; Peter Melsheimer; Heike Sartor; Lars-Christian Horn; Michael Höckel; Magnus von Knebel Doeberitz

254

Vulvar inflammation as the only clinical manifestation of Crohn disease in an 8-year-old girl.  

PubMed

Recognition of Crohn disease in children who present with cutaneous vulvar lesions as their initial clinical manifestation is often difficult. We report here the case of an 8-year-old girl with chronic vulvar edema, which on biopsy revealed granulomatous inflammation of the vulva. Further investigation and biopsy of the terminal ileum demonstrated similar findings and was consistent with a diagnosis of Crohn disease. PMID:20457677

Corbett, Shannon L; Walsh, Catharine M; Spitzer, Rachel F; Ngan, Bo-Yee; Kives, Sari; Zachos, Mary

2010-06-01

255

examining low self-control theory at mardi gras: critiquing the general theory of crime within the framework of normative deviance  

Microsoft Academic Search

This exploratory study situates the theory of low self-control within the framework of normative deviance. Empirically, it tests whether self-reported acts of deviance committed prior to attending Mardi Gras predict self-reported acts of lewd behavior during Mardi Gras in New Orleans. Lewd conduct at Mardi Gras is defined as the exposure of one's genitals, anus, vulva, or female breast nipples,

Davis Redmon

2003-01-01

256

Comparative vaginal cytology of the estrous cycle of black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo).  

PubMed

Vaginal cytology and vulva size were used to characterize the reproductive cycle of female black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo). Emphasis was on black-footed ferrets because of the need to breed these critically endangered animals and on Siberian polecats because of the close taxonomic relationship to black-footed ferrets. Vaginal cytology of the 3 species of ferret is similar. Proestrus was characterized by an increasing percentage of superficial epithelial cells and enlargement of the vulva. During estrus, superficial cells were usually greater than or equal to 90% of epithelial cells in the vaginal lavage and after several days were fully keratinized. Neutrophils were more common during all stages of the estrous cycle in domestic ferrets than they were in the other species. Following copulation, percentage of superficial calls in the vagina declined and vulva swelling subsided. Large cells, probably of uterine symplasma origin, were observed in vaginal lavages following whelping or pseudopregnancy. Vaginal cytology is extremely useful in the reproductive management of black-footed ferrets and Siberian polecats. Knowledge of normal vaginal cytology could be applied to the diagnosis of female reproductive abnormalities in all 3 species. PMID:1554767

Williams, E S; Thorne, E T; Kwiatkowski, D R; Lutz, K; Anderson, S L

1992-01-01

257

Protein kinase VRK-1 regulates cell invasion and EGL-17/FGF signaling in Caenorhabditis elegans.  

PubMed

The vaccinia-related kinases (VRKs) are highly conserved throughout the animal kingdom and phosphorylate several chromatin proteins and transcription factors. In early Caenorhabditis elegans embryos, VRK-1 is required for proper nuclear envelope formation. In this work, we present the first investigation of the developmental role of VRKs by means of a novel C. elegans vrk-1 mutant allele. We found that VRK-1 is essential in hermaphrodites for formation of the vulva, uterus, and utse and for development and maintenance of the somatic gonad and thus the germ line. VRK-1 regulates anchor cell polarity and the timing of anchor cell invasion through the basement membranes separating vulval and somatic gonadal cells during the L3 larval stage. VRK-1 is also required for proper specification and proliferation of uterine cells and sex myoblasts. Expression of the fibroblast growth factor-like protein EGL-17 and its receptor EGL-15 is reduced in vrk-1 mutants, suggesting that VRK-1 might act at least partially through activation of FGF signaling. Expression of a translational VRK-1Colon, two colonsGFP fusion protein in the ventral nerve cord and vulva precursor cells restores vulva and uterus formation, suggesting both cell autonomous and non-autonomous roles of VRK-1. PMID:19679119

Klerkx, Elke P F; Alarcón, Pilar; Waters, Katherine; Reinke, Valerie; Sternberg, Paul W; Askjaer, Peter

2009-11-01

258

Advanced Clinical Interpretation of the WAIS-IV and WMS-IV: Prevalence of Low Scores Varies by Level of Intelligence and Years of Education  

ERIC Educational Resources Information Center

Clinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Memory Scale-Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients…

Brooks, Brian L.; Holdnack, James A.; Iverson, Grant L.

2011-01-01

259

Anaplastic clear cell ependymoma of the conus medullaris and cauda equina in a 3-year-old child.  

PubMed

Only a minority of ependymomas present in the spinal cord. We report on a child with recurrence of a rare anaplastic clear cell type of ependymoma. This was initially misdiagnosed as a World Health Organization grade I myxopapillary ependymoma because this type of ependymoma occurs more commonly and the magnetic resonance imaging features and location at the conus medullaris were considered characteristic. PMID:22009009

Eshraghi, Hoda; Andronikou, Savvas; Fisher-Jeffes, Norman; Truter, Rene; Walt, Adri v d

2012-05-01

260

Solitary fibrous tumor (SFT) of the pelvis  

Microsoft Academic Search

Solitary fibrous tumors (SFTs) are well recognized in the pleura, but their occurrence at other sites has only become appreciated in recent years, as a consequence of which extrapleural examples often go unrecognized and misdiagnosed. Because of their rarity, overall experience concerning this tumor has not been significant and reports detailing radiological findings are few. We herein report an unusual

Shiu Yan J. Wat; Monalisa Sur; Kavita Dhamanaskar

2008-01-01

261

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome  

Microsoft Academic Search

Cyclic vomiting syndrome (CVS) is a disorder noted for its unique intensity of vomiting, repeated emergency department visits and hospitalizations, and reduced quality of life. It is often misdiagnosed due to the unappreciated pattern of recurrence and lack of confirmatory testing. Because no accepted approach to management has been established, the task force was charged to develop a report on

B UK Li; Frank Lefevre; Gisela G Chelimsky; Richard G Boles; Susanne P Nelson; Donald W Lewis; Steven L Linder; Robert M Issenman; Colin D Rudolph

2008-01-01

262

A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis  

Microsoft Academic Search

BACKGROUND: Neuromyelitis optica is an inflammatory demyelinating disease with generally poor prognosis that selectively targets optic nerves and spinal cord. It is commonly misdiagnosed as multiple sclerosis. Neither disease has a distinguishing biomarker, but optimum treatments differ. The relation of neuromyelitis optica to optic-spinal multiple sclerosis in Asia is uncertain. We assessed the capacity of a putative marker for neuromyelitis

V. A. Lennon; D. M. Wingerchuk; T. J. Kryzer; S. J. Pittock; C. F. Lucchinetti; K. Fujihara; I. Nakashima; B. G. Weinshenker

2004-01-01

263

Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.  

ERIC Educational Resources Information Center

Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

Cochran, Brent

264

Carbon monoxide poisoning — a public health perspective  

Microsoft Academic Search

Carbon monoxide (CO) may be the cause of more than one-half of the fatal poisonings reported in many countries; fatal cases also are grossly under-reported or misdiagnosed by medical professionals. Therefore, the precise number of individuals who have suffered from CO intoxication is not known. The health effects associated with exposure to CO range from the more subtle cardiovascular and

James A. Raub; Monique Mathieu-Nolf; Neil B. Hampson; Stephen R. Thom

2000-01-01

265

Hydatid pulmonary emboli.  

PubMed

A case of secondary hydatosis, initially misdiagnosed as pulmonary metastases, is presented. The dissemination of hydatid cysts within the lungs in this case was the consequence of direct rupture of a hepatic hydatid into the inferior vena cava. A brief overview of the pathophysiology of hydatid disease, including a discussion of the types of hydatid rupture (contained, communicating and direct), is presented. PMID:11903187

Smith, G J; Irons, S; Schelleman, A

2001-11-01

266

Clinical Characteristics and Treatment Responses in Cases Diagnosed as Reactive Attachment Disorder  

Microsoft Academic Search

The aim of our study is to report the relation between pathological care and impairment in social interaction, communication, language development, and stereotypical behaviors. Fifteen cases (9 boys, 6 girls) who have the symptoms listed above and who were misdiagnosed with pervasive developmental disorder (PDD), were referred to our clinic for evaluation and treatment. After the cases were evaluated by

Nahit Motavalli Mukaddes; Sumru Bilge; Behiye Alyanak; Meltem Eröcal Kora

2000-01-01

267

Segmental ulcerated perineal hemangioma of infancy: a complex case of PELVIS syndrome successfully treated using a multidisciplinary approach.  

PubMed

We report a case of PELVIS (perineal hemangioma, external genital malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus and skin tag) syndrome in which hemangioma in the perineal area was misdiagnosed at birth as diaper rash. Investigations revealed associated vesicorenal and spinal abnormalities. We emphasize careful diagnosis of suspicious lesions at birth and confirm the successful use of propranolol in treating ulcerated segmental hemangiomas. PMID:23278237

Kaushik, Shivani B; Kwatra, Shawn G; McLean, Thomas W; Powers, Alexander; Atala, Anthony J; Yosipovitch, Gil

2013-01-01

268

Atypical teratoid\\/rhabdoid tumors  

Microsoft Academic Search

Case reports. We describe three cases of atypical ATRT that were identified at the Children's Hospital of Eastern Ontario. Discussion. Over the past decade, atypical teratoid\\/rhabdoid tumors (ATRTs) of the central nervous system have emerged as a distinct entity. This tumor is typically misdiagnosed as a primitive neuroectodermal tumor (PNET)\\/medulloblastoma. The unique immunohistochemistry profile of an ATRT helps distinguish it

Tommy Dang; Michael Vassilyadi; Jean Michaud; Carmencita Jimenez; Enrique C. G. Ventureyra

2003-01-01

269

Screening for primary hyperparathyroidism before thyroid surgery: A prospective study  

Microsoft Academic Search

Background. Misdiagnosed primary hyperparathyroidism (PHPT) during thyroid surgery may lead to a difficult reoperation. Because PHPT is often asymptomatic, calcium measurements have been recommended before thyroid surgery, but no study has focused on the results of a prospective PHPT screening. Methods. The prospective study of 748 patients consisted of 2-step screening of calcium measurement in all patients (normal range, 2.2

Anne Denizot; Frédéric Dadoun; Anne Meyer-Dutour; Pierre Alliot; Maxime Argème

2002-01-01

270

Lung Cancer Diseases Diagnostic Asistance Using Gray Color Analysis  

Microsoft Academic Search

Errors in diagnosing the disease is a critical risk that must be faced by any person giving treatment to the hospital. Medical treatment can not always be done with perfect accuracy. Lung cancer is one of the most deadly disease that prone to misdiagnose. In general, some practitioners tend to “read” cancer in x-ray rontgen image as tumor this could

P. Paulus; F. L. Gaol

2010-01-01

271

Oral and maxillofacial surgery in patients with chronic orofacial pain  

Microsoft Academic Search

Purpose: In this investigation, we evaluated a population of patients with chronic orofacial pain who sought treatment at a pain center in an academic institution. These patients were evaluated with respect to 1) the frequency and types of previous oral and maxillofacial surgery procedures, 2) the frequency of previous significant misdiagnoses, and 3) the number of patients who subsequently required

Howard A. Israel; John Desmond Ward; Brenda Horrell; Steven J. Scrivani

2003-01-01

272

The psychological burden of an initially unexplained illness: patients with sternocostoclavicular hyperostosis before and after delayed diagnosis  

Microsoft Academic Search

BACKGROUND: Sternocostoclavicular hyperostosis (SCCH) is a rare, debilitating, chronic inflammatory disorder of the anterior chest wall due to a chronic sterile osteomyelitis of unknown origin. SCCH is largely underdiagnosed and often misdiagnosed. In individual cases it can remain unrecognized for years. The purpose of this study is twofold. Firstly, to evaluate the psychological condition of SCCH patients, both in the

Willem A van der Kloot; Neveen AT Hamdy; Laurian CS Hafkemeijer; Femke MC den Dulk; Sadhna A Chotkan; Arnold AP van Emmerik; Ad A Kaptein

2010-01-01

273

Abdominal emergencies in the geriatric patient  

PubMed Central

Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

2014-01-01

274

[Epiploic appendagitis: report of a case].  

PubMed

Primary epiploic appendagitis are considered to be a rare cause of acute abdomen. They are frequently misdiagnosed as either acute appendicitis or acute diverticulitis and the diagnosis is usually made during surgery. We report a case in which computed tomography (CT) suggested the diagnosis and helped in avoiding unnecessary surgery. PMID:18706783

Bonnefoy, S; Corberand, D; Sinayoko, L; Harnois, F; Mennecier, D; Thiolet, C

2008-12-01

275

Primary epiploic appendagitis: a report of two cases  

Microsoft Academic Search

Primary epiploic appendagitis (PEA) is a rare benign self-limiting inflammatory process of the colonic epiploic appendices. Patients present with acute abdominal pain, often misdiagnosed clinically as acute appendicitis or diverticulitis. Computed tomography (CT) scan findings of this condition are characteristic and can confidently suggest the diagnosis avoiding unnecessary barium enemas and colonoscopy, biopsy, or surgery.

Ghina A. Birjawi; Maurice C. Haddad; Hala M. Zantout; Suheil Z. Uthman

2000-01-01

276

Uncommon cause of acute abdominal pain at the emergency room: epiploic appendagitis.  

PubMed

This is a case of 49 year-old-female with left lower quadrant pain. Initial diagnosis of acute diverticulitis entertained and treated accordingly. Diagnosis of epiploic appendagitis was done by abdominal CT-Scan. Epiploic appendagitis is commonly misdiagnosed as diverticulitis and appendicitis. Non-invasive studies may lead to early diagnosis avoiding unnecessary hospitalizations, antibiotic therapy and surgical intervention. PMID:21696102

Maldonado-Rivera, Sandra N; Calviño-Acosta, Lázaro; Santiago-Casiano, Mónica; de Lourdes Miranda, María; Mercedes Maldonado, Milciades; Hernan Martínez, José

2011-01-01

277

Male Anorexia Nervosa: A New Focus.  

ERIC Educational Resources Information Center

Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better…

Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

2000-01-01

278

A young man with altered mental status and new-onset seizures.  

PubMed

Signs and symptoms of a subacute, progressive, imaging-negative encephalopathy can be misdiagnosed as a neuropsychiatric or progressive neurodegenerative disorder. However, encephalopathies often can be reversed if the autoimmune component is recognized early through a careful history and diagnostic testing, including cerebrospinal fluid analysis for antibodies. PMID:24201920

Cassa, Richard S; Rosengart, Axel J

2013-10-01

279

Transient synovitis of the hip as a complication of chickenpox in infant: Case study.  

PubMed

Chickenpox has many rare complications; transient synovitis is one of the very painful and self-limiting rare complications. This patient suffered from transient synovitis associated with chickenpox. After being diagnosed, it was managed by diclofenac sodium suppositories. Physicians must be able to correlate all of the possible complications of chickenpox in order to avoid misdiagnoses. PMID:23960801

Alomar, Muaed Jamal

2012-07-01

280

Transient synovitis of the hip as a complication of chickenpox in infant: Case study  

PubMed Central

Chickenpox has many rare complications; transient synovitis is one of the very painful and self-limiting rare complications. This patient suffered from transient synovitis associated with chickenpox. After being diagnosed, it was managed by diclofenac sodium suppositories. Physicians must be able to correlate all of the possible complications of chickenpox in order to avoid misdiagnoses. PMID:23960801

Alomar, Muaed Jamal

2012-01-01

281

June 6, June 22, August 29, 2006 New abstract, Nov. 1, 2006  

E-print Network

excisions; old Section 7 removed; February 17, 2007 Ignorance and Indifference John D. Norton Center innocuous as almost to be platitudes. Yet the literature in probabilistic epistemology has misdiagnosed them in the literature and are described in Section 2. They are the familiar principle of indifference ("PI") and also

282

June 6, June 22, August 29, 2006 New abstract, Nov. 1, 2006  

E-print Network

and Indifference John D. Norton Center for Philosophy of Science and Department of History and Philosophy the literature in probabilistic epistemology has misdiagnosed them as paradoxical or defective since already exist in the literature and are described in Section 2. They are the familiar principle

283

Appendectomy due to lead poisoning: a case-report  

Microsoft Academic Search

BACKGROUND: Lead poisoning is a common occupational health hazard in developing countries and many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms. CASE PRESENTATION: We report a case of occupational lead poisoning in an adult battery worker with abdominal colic who initially underwent appendectomy with removal of normal appendix. Later on he was diagnosed with lead

S Mohammadi; AH Mehrparvar; M Aghilinejad

2008-01-01

284

Sanctuary or Sanction?  

ERIC Educational Resources Information Center

A Harvard study suggests that minority students are often misdiagnosed as mentally retarded or behaviorally disabled; African-Americans are overrepresented in special-education classes and trail whites in achievement. Students are frequently placed in separate classes or schools. Predictable classroom routines can help kids with behavior problems.…

Newsom, John

2001-01-01

285

Odontogenic Cutaneous Fistula  

PubMed Central

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics. PMID:21509218

Samir, Nafisa; Al-Mahrezi, Abdulaziz; Al-Sudairy, Salim

2011-01-01

286

Circadian rhythm sleep disorders (CRSD)  

Microsoft Academic Search

Circadian Rhythm Sleep Disorders (CRSD) are a group of sleep disorders characterized by a malsynchronization between a person's biological clock and the environmental 24-h schedule. These disorders can lead to harmful psychological and functional difficulties and are often misdiagnosed and incorrectly treated due to the fact that doctors are unaware of their existence. In the following review we describe the

Yaron Dagan

2002-01-01

287

Delirium scales: A review of current evidence  

Microsoft Academic Search

Objectives: Delirium is a common neuropsychiatric condition with many adverse outcomes in elderly populations including death. Despite this, it is often misdiagnosed and mistreated. A number of scales can be used to detect delirium. We review scales that have been used in delirium studies and report their psychometric properties.Method: An extensive MEDLINE database search and subsequent examination of reference lists

Dimitrios Adamis; Naveen Sharma; Paul J. P. Whelan; Alastair J. D. Macdonald

2010-01-01

288

Submission of Fish for Diagnostic Evaluation1 RuthEllen Klinger and Ruth Francis-Floyd2  

E-print Network

FA55 Submission of Fish for Diagnostic Evaluation1 RuthEllen Klinger and Ruth Francis-Floyd2 1 Determining the cause of a fish's illness and death can be difficult and frustrating for anyone who works with fish. Disease problems are commonly misdiagnosed and fish are often incorrectly treated with over

Watson, Craig A.

289

Optimal Outcome in Individuals with a History of Autism  

ERIC Educational Resources Information Center

Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a…

Fein, Deborah; Barton, Marianne; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Orinstein, Alyssa; Rosenthal, Michael; Troyb, Eva; Tyson, Katherine

2013-01-01

290

Cerebral macroabscess caused by Candida albicans in an immunocompetent patient: A diagnostic challenge  

PubMed Central

We describe the history of a 24-year-old immunocompetent man with an expansive lesion in the brainstem that, after many misdiagnoses, was found to be caused by a Candida albicans abscess. One year after surgery and 3 months of fluconazole treatment, the patient was asymptomatic and all image and laboratory tests were normal. PMID:24567895

Figueiredo, Sônia M.; Campolina, Sabrina; Rosa, Carlos A.; Gontijo, Marcus; Tirone, Thelma; Assunção, Claudia B.; Freire, Tarcísio F.A.; Christo, Paulo P.; Caligiorne, Rachel B.

2014-01-01

291

Sonographic appearance of uterine lymphoma: Case report and review of the literature.  

PubMed

Uterine lymphoma is rare and tends to be misdiagnosed due to lack of specific radiologic features. Few reports have been published on the sonographic characteristics of uterine lymphoma. We present a case report of uterine lymphoma manifested by a fast growing uterus and describe the sonographic findings. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 43:59-63, 2015. PMID:24796529

Hadi, Efrat; Bruchim, Ilan; Helman, Ilana; Shehtman, Itshak; Stackievicz, Rodica; Tepper, Ronnie; Hershkovitz, Reli

2015-01-01

292

A case of peduncular hallucinosis presenting as a primary psychiatric disorder  

PubMed Central

Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder. PMID:24339609

Dogan, Vasfiye Burcu; Dirican, Ayten; Koksal, Ayhan; Baybas, Sevim

2013-01-01

293

Three Cases of Subungual Glomus Tumours of the Fingers – A Case Series  

PubMed Central

Subungual glomus tumours are rare tumours (2% of all hand tumours) presenting with excruciating pin point pain under the nail which is often misdiagnosed. Diagnosis is often always clinical. Here, we report the case of three patients who had subungual glomus tumour not diagnosed earlier for many years. PMID:25478395

Raja, D Alagar

2014-01-01

294

Coccidioides Immitis: Two Cases of Misidentified Mycosis  

PubMed Central

In the present report, two cases of pulmonary coccidioidomycosis that caused a diagnostic confusion are presented. The first case was initially misdiagnosed as nonsmall cell carcinoma, and both cases were initially misidentified as blastomycosis because of the presence of an atypical morphological form of Coccidioides immitis. PMID:18949109

Lee, Christine H; Wilcox, Lindsay; Chorneyko, Katherine; McIvor, Andrew

2008-01-01

295

Flow accelerated corrosion  

SciTech Connect

Flow accelerated corrosion has recently attracted attention in association with heat recovery steam generators. Apparently, the phenomenon is more widespread than is realized and has been misdiagnosed as simple erosion. This paper addresses the principal environmental conditions that have been linked to flow accelerated corrosion and it illustrates the phenomenon with case histories.

Port, R.D. [Nalco Chemical Co., Naperville, IL (United States)

1998-12-31

296

THEORETICAL ADVANCES Joint feature selection and classification for taxonomic problems  

E-print Network

to a taxonomic problem involving species of suckers in the genus Carpiodes. The results confirm the necessity have traditionally been misdiagnosed as C. carpio but are in fact more close to C. cyprinus. We also Carpiodes. The results look promising: the proposed method not only learned the classifier that well

Bart Jr., Henry L. "Hank"

297

Dedifferentiated chordoma with a sarcomatous component: an overlooked diagnosis.  

PubMed

A 60 year old male presented with unremitting complaints of acute urinary retention and constipation. Computerized Tomography of the abdomen and pelvis confirmed a sacral mass. The biopsy diagnosed dedifferentiated sacral chordoma; an extremely rare entity, seldom reported and frequently misdiagnosed. We present a unique case report after an extensive review of retrospective literature on dedifferentiated chordomas. PMID:20364771

Masood, Quratulain; Bilal, Mohammad; Tariq, Ayesha; Khan, Somal; Qureshi, Asad

2009-01-01

298

Rare adipose disorders (RADs) masquerading as obesity  

Microsoft Academic Search

Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue

Karen L Herbst

2012-01-01

299

Acampomelic form of campomelic dysplasia with SOX9 missense mutation.  

PubMed

Campomelic dysplasia is a skeletal dysplasia characterized by flat face, Pierre Robin sequence, shortening and bowing of long bones and club feet. The authors describe a case of "acampomelic" campomelic dysplasia that differs from classical campomelic dysplasia by the absence of bone bowing. This condition is among the most common skeletal dysplasias but is often misdiagnosed in the absence of overt campomelia. PMID:23564514

Gopakumar, Hariharan; Superti-Furga, Andrea; Unger, Sheila; Scherer, Gerd; Rajiv, P K; Nampoothiri, Sheela

2014-01-01

300

Brief Education About Autism Spectrum Disorders for Family Therapists  

Microsoft Academic Search

The prevalence of autism spectrum disorders (ASDs) is on the rise, and family therapists are increasingly likely to encounter clients who have some form of this disorder. There is emerging evidence that professionals, including family therapists, may misdiagnose the condition or that proper diagnosis and treatment may be delayed. Thus, professional education about ASDs is important. In addition to the

Kay Bradford

2010-01-01

301

Fractures of the Triquetrum  

Microsoft Academic Search

The commonest carpal fractures are those of the carpal scaphoid. Triquetral fractures are relatively uncommon, but when present, often go undiagnosed or are misdiagnosed as lunate fractures. Clinical suspicion and careful evaluation of the appropriate radiographs, especially an oblique view, should ensure the diagnosis.

J. De V. De BEER; D. A. HUDSON

1987-01-01

302

Kounis syndrome: myocardial infarction secondary to an allergic insult--a rare clinical entity.  

PubMed

The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the first incident. PMID:21894822

Caglar, Fatma N T; Caglar, Ilker M; Coskun, Ugur; Ugurlucan, Murat; Okcun, Baris

2011-08-01

303

Orbital rosai-dorfman disease in a five-year-old boy.  

PubMed

Rosai-Dorfman disease (RDD) is characterized by histiocytic proliferation and massive cervical lymphadenopathy, although some patients have extra-nodal involvement. We report a case of extranodal RDD in a five-year-old child, initially misdiagnosed as orbital inflammatory disease and treated with oral steroids. A subsequent orbital biopsy three years later confirmed the diagnosis of Rosai Dorfman disease. PMID:22224025

Al-Moosa, Ashref J; Behbehani, Raed S; Hussain, Abdulmohsen E; Ali, Abdullah E

2011-10-01

304

Orbital Rosai–Dorfman Disease in a Five-Year-Old Boy  

PubMed Central

Rosai–Dorfman disease (RDD) is characterized by histiocytic proliferation and massive cervical lymphadenopathy, although some patients have extra-nodal involvement. We report a case of extranodal RDD in a five-year-old child, initially misdiagnosed as orbital inflammatory disease and treated with oral steroids. A subsequent orbital biopsy three years later confirmed the diagnosis of Rosai Dorfman disease. PMID:22224025

Al-Moosa, Ashref J.; Behbehani, Raed S.; Hussain, Abdulmohsen E.; Ali, Abdullah E.

2011-01-01

305

Early Identification of Learning Disabilities: A Comparison of Two Methods.  

ERIC Educational Resources Information Center

An unadjusted low-achievement criterion was compared with a regression-discrepancy criterion for identifying learning disabled children. The use of an unadjusted achievement raw score criterion resulted in misdiagnosing many children as learning disabled, while failing to identify many others. Different sets of predictor variables were associated…

Horn, Wade F.; O'Donnel, James P.

1984-01-01

306

Urinary incontinence.  

PubMed Central

Incontinence has about a 15 percent prevalence among elderly women. Some of the factors associated with incontinence are psychosocial implications of stigmatization, the decreased quality of life, and the economic considerations of nursing home costs. There are numerous, often misdiagnosed, reversible causes of incontinence, and many of the problems associated with aging may be alleviated if incontinence is treated symptomatically and controlled. PMID:3120223

Resnick, N M

1987-01-01

307

Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.  

ERIC Educational Resources Information Center

Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize…

Budd, Linda S.

308

Clinical characteristics of a South Indian cohort of juvenile myoclonic epilepsy probands  

Microsoft Academic Search

Despite the distinctive clinical and electroencephalographic features known for five decades, even today, juvenile myoclonic epilepsy (JME) is frequently unrecognised and misdiagnosed in both developed and developing countries. Utilising 183 JME probands belonging to the South Indian state of Kerala, assembled through a tertiary referral centre for molecular genetic studies, we explored the phenotypic peculiarities, clinical genetics, and problems and

J VIJAI; P. J CHERIAN; P. N SYLAJA; A ANAND; K RADHAKRISHNAN

2003-01-01

309

Lyme Disease: Implications for Health Educators.  

ERIC Educational Resources Information Center

Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

Harbit, Maryanne Drake; Willis, Dawn

1990-01-01

310

Changes in the Levels of Interferon-? and Transforming Growth Factor-? Influence Bronchial Stenosis during the Treatment of Endobronchial Tuberculosis  

Microsoft Academic Search

Background: Endobronchial tuberculosis (EBTB) has been shown to frequently complicate bronchial stenosis, a condition which can induce dyspnea as a result of airway obstruction, and is also frequently misdiagnosed as either bronchial asthma or lung cancer. Objectives: This study attempted to determine whether there was a correlation between interferon-? (IFN-?) and transforming growth factor-? (TGF-?) levels in the serum and

Y. Kim; K. Kim; J. Joe; M. Lee; Y. Choi

2007-01-01

311

A Preliminary Report on the English Phonology of Typically Developing English-Mandarin Bilingual Preschool Singaporean Children  

ERIC Educational Resources Information Center

Background: There are no published data on typical phonological development for Singaporean children. There is therefore the risk that children's speech in Singapore may be misdiagnosed or that clinicians may set goals erroneously. Aims: This paper reports a preliminary study on the English phonology of typically developing 4;0-4;5-year-old…

En, Lydea Gn Wei; Brebner, Chris; McCormack, Paul

2014-01-01

312

Intracardiac leiomyomatosis complicated by pulmonary embolism: a multimodality imaging case of a rare entity.  

PubMed

We present a case of intravenous leiomyomatosis with intracaval and right ventricle extension that was misdiagnosed as venous thrombus. Part of the mass had split and embolized the pulmonary artery, requiring urgent surgery. Although the mass fragments were removed from the inferior vena cava, right ventricle, and pulmonary artery successfully, this case clearly shows the importance of prompt surgery. PMID:24267816

Ribeiro, Vânia; Almeida, Jorge; Madureira, António J; Lopez, Elisa; Machado, Luís; Albuquerque, Roncon; Pinho, Paulo

2013-12-01

313

Zika Virus Infection Acquired During Brief Travel to Indonesia  

PubMed Central

Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

Kwong, Jason C.; Druce, Julian D.; Leder, Karin

2013-01-01

314

Zika virus infection acquired during brief travel to Indonesia.  

PubMed

Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

Kwong, Jason C; Druce, Julian D; Leder, Karin

2013-09-01

315

Characterization of the Complete Mitochondrial Genome Sequence of Spirometra erinaceieuropaei (Cestoda: Diphyllobothriidae) from China  

PubMed Central

Sparganosis, caused by the plerocercoid larvae of members of the genus Spirometra, can cause significant public health problem and considerable economic losses. In the present study, the complete mitochondrial DNA (mtDNA) sequence of Spirometra erinaceieuropaei from China was determined, characterized and compared with that of S. erinaceieuropaei from Japan. The gene arrangement in the mt genome sequences of S. erinaceieuropaei from China and Japan is identical. The identity of the mt genomes was 99.1% between S. erinaceieuropaei from China and Japan, and the complete mtDNA sequence of S. erinaceieuropaei from China is slightly shorter (2 bp) than that from Japan. Phylogenetic analysis of S. erinaceieuropaei with other representative cestodes using two different computational algorithms [Bayesian inference (BI) and maximum likelihood (ML)] based on concatenated amino acid sequences of 12 protein-coding genes, revealed that S. erinaceieuropaei is closely related to Diphyllobothrium spp., supporting classification based on morphological features. The present study determined the complete mtDNA sequences of S. erinaceieuropaei from China that provides novel genetic markers for studying the population genetics and molecular epidemiology of S. erinaceieuropaei in humans and animals. PMID:22553464

Liu, Guo-Hua; Li, Chun; Li, Jia-Yuan; Zhou, Dong-Hui; Xiong, Rong-Chuan; Lin, Rui-Qing; Zou, Feng-Cai; Zhu, Xing-Quan

2012-01-01

316

Praziquantel Treatment in Trematode and Cestode Infections: An Update  

PubMed Central

Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried. PMID:24265948

2013-01-01

317

Zoonotic helminths affecting the human eye  

PubMed Central

Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE) may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis), food consumption (sparganosis, trichinellosis) and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis). Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs) or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber) causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears PMID:21429191

2011-01-01

318

Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)  

PubMed Central

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook

2014-01-01

319

The identification of a Clonorchis sinensis gene encoding an antigenic egg protein.  

PubMed

The cDNA library of Clonorchis sinensis was screened for genes encoding antigenic proteins by using sera from clonorchiasis patients. A gene of 888 bp encoding a 28-kDa protein (Cs28) was cloned and found to contain a high percentage of glycine (20%), tyrosine (11%), and lysine (11%). The amino acid sequence of Cs28 showed 60% homology with the vitelline B precursor protein of Opisthorchis viverrini and of 33% homology with the vitelline B1 and B2 proteins of Fasciola hepatica. A strong positive reaction was observed in the intrauterine eggs of adult C. sinensis by immunohistochemical analysis using specific immune sera against recombinant Cs28 protein (rCs28). By immunoblot analysis, rCs28 displayed an antigenic reaction with 73% of the serum samples from 115 cases of clonorchiasis. In addition, it cross-reacted with the sera of 77.5% of 40 opisthorchiasis cases, 90% of 20 schistosomiasis cases, and 50% of 10 paragonimiasis cases. However, no cross-reactions were observed with the sera of sparganosis or cysticercosis patients. In conclusion, the Cs28 protein was identified as an egg protein of C. sinensis and as an antigen common to the trematode species examined. PMID:15616856

Lee, Mejeong; Chung, Young-Bae; Lee, Suk-Keun; Chung, Byung-Suk; Li, Shunyu; Choi, Min-Ho; Hong, Sung-Tae

2005-02-01

320

Serodiagnosis of Toxocariasis by ELISA Using Crude Antigen of Toxocara canis Larvae  

PubMed Central

Toxocariasis is a worldwide zoonosis caused by larvae of ascarid nematodes of dogs or cats, Toxocara canis or T. cati. Diagnosis of human toxocariasis currently relies on serology that uses T. canis excretory-secretory antigen to detect specific IgG antibodies by ELISA. We investigated the serodiagnostic efficacy of ELISA using crude antigen of T. canis larvae (TCLA). Serum specimens of 64 clinically confirmed toxocariasis, 115 healthy controls, and 119 other tissue-invading helminthiases were screened by ELISA using TCLA. The ELISA using TCLA showed 92.2% (59/64 patient samples) sensitivity and 86.6% (103/119) specificity. Its positive diagnostic predictivity was 78.7% and negative predictivity was 97.8%. No serum of healthy controls reacted but that of anisakiasis (45.5%), gnathostomiasis (19.2%), clonorchiasis (15.8%), sparganosis (11.1%), and cysticercosis (6.3%) cross-reacted. Immunoblot analysis on TCLA recognized antigenic proteins of 28- and 30-kDa bands in their dominant protein quantity and strong blotting reactivity. The present results indicate that the ELISA using our TCLA antigen is acceptable by the sensitivity and specificity for serodiagnosis of human toxocariasis. ELISA with TCLA is recommended to make differential diagnosis for patients with any sign of organ infiltration and eosinophilia. PMID:24039286

Jin, Yan; Shen, Chenghua; Huh, Sun; Sohn, Woon-Mok; Choi, Min-Ho

2013-01-01

321

Parasitic infections based on 320 clinical samples submitted to Hanyang University, Korea (2004-2011).  

PubMed

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook; Ahn, Myoung-Hee

2014-04-01

322

Praziquantel treatment in trematode and cestode infections: an update.  

PubMed

Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried. PMID:24265948

Chai, Jong-Yil

2013-03-01

323

Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.  

PubMed

Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications. PMID:25190008

Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

2014-11-01

324

Description of Hemicaloosia graminis n. sp. (Nematoda: Caloosiidae) Associated with Turfgrasses in North and South Carolina, USA  

PubMed Central

A new nematode species was discovered during a diversity survey of plant-parasitic nematodes on turfgrass conducted in North and South Carolina in 2010 and 2011. It is described herein as Hemicaloosia graminis n. sp. and is characterized by two annuli in the lip region, one lateral line, body 610.0–805.0 ?m long, stylet 65.0–74.6 ?m long, vulva at 84.1% –85.8% of the body , 254–283 annuli, vulva at the 38–53rd annulus from tail terminus, 12–14 annuli between vulva and anus, tail elongate-pointed, 67.5–84.8 ?m long in females and spicule straight, 31.0 ?m long, caudal alae well developed, two lateral lines in males. The newly described species is morphologically closest to H. paradoxa, but has a longer stylet (65.0–74.6 vs 61.0–65.0 ?m) and a higher V-value (84.1–85.8 vs 78.1–84.0%), less RV (38–53 vs 50–56), higher RVan (12–14 vs 10) in females, and a shorter tail (30.1 vs 36.7 ?m) and more anteriorly located excretory pore (105.9 vs 140.0 ?m) in the male. It was easily differentiated from other species based on near-full-length small subunit rRNA gene (SSU) and ITS1 sequences. Phylogenetic analysis from SSU supports placement in a monophyletic clade with the genus Caloosia. An identification key and a table of distinguishing characteristics are presented for all seven species of Hemicaloosia. PMID:23482701

Zeng, Yongsan; Ye, Weimin; Tredway, Lane; Martin, Samuel; Martin, Matt

2012-01-01

325

Disseminated transmissible venereal tumour associated with Leishmaniasis in a dog.  

PubMed

This report addresses an atypical transmissible venereal tumour in an 8-year-old bitch that was pluriparous and seropositive for leishmaniasis. There were ascites and a serosanguineous discharge from the vulva, but no lesions on the external genital mucosa. An aspirate of the peritoneal fluid showed mononuclear round cells characteristic of transmissible venereal tumour (TVT). Exploratory laparotomy revealed light red, granulomatous structures in the peritoneum, omentum, spleen, liver and uterine horns. Cytological and histopathological tests confirmed the diagnosis of intra-abdominal TVT. Dissemination of the TVT to several organs inside the abdominal cavity probably resulted from immunosuppression caused by leishmaniasis, which favoured the presence and aggressiveness of TVT. PMID:23279537

Trevizan, J T; Carreira, J T; Souza, N C; Carvalho, I R; Gomes, P B C; Lima, V M F; Orlandi, C M B; Rozza, D B; Koivisto, M B

2012-12-01

326

Extra Mammary Paget's Disease: A Rare Case Report.  

PubMed

Extramammary Paget's disease is a marginated plaque resembling Paget's disease but occurring in anogenital area, axilla or most commonly on the vulva. A 62-year-old postmenopausal woman presented with extremely pruritic plaque on the perineal skin which progressed gradually over 3 years and did not respond to any topical/systemic steroids, antibiotics, and antifungals. Examination revealed 7 × 8 cm. hypertrophic, verrucous plaque with erosions, and crusts at places. There was no evidence of visceral malignancy. Biopsy showed Paget's cells which were positive for Periodic Acid Schiff and alcian blue stain. Surgical excision was done considering the premalignant potential. PMID:25657432

Sardesai, Vidyadhar R; Agarwal, Trupti D; Sakhalkar, Sarita P

2015-01-01

327

Rhizonema sequoiae n.gen. n.sp. from Coast Redwood Sequoia sempervirens (D.Don) Endl.  

PubMed Central

Rhizonema sequoiae n.gen, u. sp. is described from the roots of Coast Redwood, Sequoia sempervirens (D. Don) Endl., growing near Lake Lagunitas, Marin County, California. Rhizonema females are annulated over their entire bodies, are wholly embedded in host tissue, and secrete an abundant amount of gel material. Mature females do not form a cyst. The vulva is located on a large posterior terminal cone, and the anus is on the dorsal vulval lip. Esophageal glands of the second-stage larvae fill more than half of the body cavity. Tails of the vermiform males are blunt, and a cloacal tubus is present. PMID:19295834

Del Prado Vera, I. Cid; Lownsbery, B. F.; Maggenti, A. R.

1983-01-01

328

Erythroplasia (Queyrat) of conjunctiva.  

PubMed

Erythroplasia of Queyrat (EQ) is an epidermoid carcinoma in situ which is histologically identical with Bowen's disease of the skin but involves mucosal surfaces. The lesion is known to occur on the glans penis, the vulva, and the oral mucosa. Two cases of EQ of the conjunctiva that developed several years after radiotherapy for basal cell carcinoma of the eyelids are here reported. The signs and symptoms closely mimicked those of chronic conjunctivitis. The lesions were excised by the microscopically controlled excision of Mohs. It is recommended that biopsy material be obtained in patients who develop a nonresolving chronic conjunctivitis, especially when there is history of radiotherapy of the eyelids. PMID:7217386

Dixon, R S; Mikhail, G R

1981-02-01

329

Using the laser to treat vulvar condylomata acuminata and intraepidermal neoplasia.  

PubMed Central

The therapeutic effectiveness of the carbon dioxide laser was evaluated in 55 women with condylomata acuminata, particularly of the vulva but also of the urethral meatus and anal region, and in 11 women with multicentric vulvar intraepidermal neoplasia. The rates of persistence and recurrence were 13% and 5% respectively for condylomata and were both 9% for intraepidermal neoplasia. Perioperative and postoperative complications occurred in 6 of the 66 cases (9%) and all were managed on an outpatient basis. Laser beam therapy is recommended as an effective and safe means of treating extensive condylomata and intraepidermal neoplasia of the external urogenital region and anal mucous membrane. PMID:6848156

Ferenczy, A.

1983-01-01

330

A rare vulvar manifestation of neurofibromatosis 1 in a teen.  

PubMed

Neurofibromatosis 1 is an autosomal dominant disorder with cutaneous findings that include multiple café-au-lait spots, axillary/inguinal freckling, dermal, and plexiform neurofibromas. Skin manifestations, including involvement of the vulva, are often the most troubling physical finding to patients. Hormonal and growth factor changes during puberty have been implicated in neurofibroma growth. In the case presented here, an exceedingly rare isolated vulvar neurofibroma without clitoral involvement became enlarged and symptomatic, requiring excisional surgery after puberty. The diffuse involvement of these tumors makes complete resection very difficult and recurrence is common. PMID:21715194

Skorupski, Josh C; Hafener, Hope K; Smith, Yolanda R; Quint, Elisabeth H

2011-10-01

331

Aggressive angiomyxoma with perineal herniation.  

PubMed

Aggressive angiomyxoma is a rare mesenchymal tumor involving the pelvic-perineal region. It occurs during the third and fourth decade of life and is predominantly seen in females. It presents clinically as a soft tissue mass in variable locations such as vulva, perianal region, buttock, or pelvis. Assessment of extent of the tumor by radiological evaluation is crucial for surgical planning; however, biopsy is essential to establish diagnosis. We present the radiological and pathological features seen in a 43-year-old female diagnosed with abdominal angiomyxoma with an unusual extension to the perineum. PMID:24987570

Narang, Seema; Kohli, Supreethi; Kumar, Vinod; Chandoke, Raj

2014-01-01

332

Atypical presentation of ovarian remnant syndrome in a dog.  

PubMed

A 2 yr old spayed female dog presented for evaluation of abdominal pain, decreased appetite, dysuria, and frantic licking of her vulva. A midventral, soft, fluctuant mass was detected on abdominal palpation. Diagnostic testing and exploratory celiotomy revealed remnant ovarian tissue and a cystic uterine remnant. The ovary and cystic uterine remnant were removed and submitted for histopathological evaluation. Ovarian remnant syndrome (ORS) is an infrequently encountered condition of dogs. This dog had none of the classic signs of estrus associated with ORS but instead presented for sharp, intermittent, abdominal pain that is similar to women with ORS. PMID:25001170

Parker, Kristen; Snead, Elisabeth

2014-01-01

333

Fournier's gangrene: review of fifteen cases.  

PubMed

Fournier's gangrene is a synergistic necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in men and the vulva in women. The process was believed to be idiopathic in initial descriptions. Fifteen patients were treated for Fournier's gangrene between 1990 and 1995 in the Departments of General Surgery and Urology, School of Medicine, Atatürk University, Erzurum, Turkey. The most common causes were perianal sepsis and urogenital diseases. Escherichia coli and Staphylococcus aureus were identified most commonly in cultures of necrotic tissue. The mortality rate was 20 per cent despite aggressive surgical debridement and broad-spectrum antibiotics. PMID:9358795

Ba?o?lu, M; Gül, O; Yildirgan, I; Balik, A A; Ozbey, I; Oren, D

1997-11-01

334

Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site  

PubMed Central

Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma. PMID:23330038

Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

2012-01-01

335

Bartholin gland carcinoma: A case report  

PubMed Central

Bartholin gland carcinomas (BGCs) are extremely rare tumors accounting for <1% of all female genital malignancies. The current study presents a 49-year-old female with an eight-year history of BGC. A mass was identified in the vulva and the patient underwent an excisional biopsy, which revealed a left Bartholin adenoid cystic carcinoma. The patient subsequently received surgery, chemotherapy and biological therapy, and has survived. Therefore, the present case indicates that surgery is important for the treatment of BGC, however; multimodal therapy may be a more effective treatment strategy. PMID:25013508

ZHAN, PING; LI, GANG; LIU, BIN; MAO, XI-GUANG

2014-01-01

336

Bartholin gland carcinoma: A case report.  

PubMed

Bartholin gland carcinomas (BGCs) are extremely rare tumors accounting for <1% of all female genital malignancies. The current study presents a 49-year-old female with an eight-year history of BGC. A mass was identified in the vulva and the patient underwent an excisional biopsy, which revealed a left Bartholin adenoid cystic carcinoma. The patient subsequently received surgery, chemotherapy and biological therapy, and has survived. Therefore, the present case indicates that surgery is important for the treatment of BGC, however; multimodal therapy may be a more effective treatment strategy. PMID:25013508

Zhan, Ping; Li, Gang; Liu, Bin; Mao, Xi-Guang

2014-08-01

337

Extra Mammary Paget's Disease: A Rare Case Report  

PubMed Central

Extramammary Paget's disease is a marginated plaque resembling Paget's disease but occurring in anogenital area, axilla or most commonly on the vulva. A 62-year-old postmenopausal woman presented with extremely pruritic plaque on the perineal skin which progressed gradually over 3 years and did not respond to any topical/systemic steroids, antibiotics, and antifungals. Examination revealed 7 × 8 cm. hypertrophic, verrucous plaque with erosions, and crusts at places. There was no evidence of visceral malignancy. Biopsy showed Paget's cells which were positive for Periodic Acid Schiff and alcian blue stain. Surgical excision was done considering the premalignant potential.

Sardesai, Vidyadhar R; Agarwal, Trupti D; Sakhalkar, Sarita P

2015-01-01

338

Cercopithifilaria leporinus n. sp. (Nematoda: Filarioidea) from the snowshoe hare (Lepus americanus Erxleben) (Lagomorpha) in Canada.  

PubMed

Cercopithifilaria leporinus n. sp. from the subcutaneous tissues of the trunk of snowshoe hares (Lepus americanus Erxleben) in Ontario and Alberta, Canada, is described. This is the only species of Dipetalonema--like filarioid known from lagomorphs. It is distinguished from other species of Cercopithifilaria by its small size, numerous mucrons on the female tail, vulva leading into a large, spherical vestibule and the pattern of papillae on the male tail. Eight species of filarioids, representing four genera, are now known from lagomorphs. Dirofilaria timidi Gubanov and Fedorov, 1966 is considered as a species inquirenda. PMID:6614747

Bartlett, C M

1983-01-01

339

Methyl - aminolevulinic acid photodynamic therapy and topical tretinoin in a patient with vulvar extramammary Paget's disease.  

PubMed

Extramammary Paget's disease is a rare neoplasm of apocrine gland-bearing areas of the skin. The most common site of presentation is the vulva. Surgery is the most frequently reported therapy so far; however, it is invasive and it is complicated by a high rate of recurrence. For this reason, several less-invasive treatments have been recently proposed, including photodynamic therapy. We describe in this article the case of an 84-year-old patient with a noninvasive vulvar extramammary Paget's disease successfully treated with methyl-aminolevulinic acid photodynamic therapy associated with topical tretinoin. PMID:23551374

Magnano, Michela; Loi, Camilla; Bardazzi, Federico; Burtica, Elena Cleopatra; Patrizi, Annalisa

2013-01-01

340

Severe hematometra in a dog with cystic endometrial hyperplasia/pyometra complex.  

PubMed

An 18-month-old, intact female German shepherd dog was presented for evaluation of severe, frank hemorrhage from the vulva. A complete blood count, serum biochemical analysis, and urinalysis supported acute hemorrhage. Abdominal radiographs were unremarkable. Abdominal ultrasound demonstrated that the uterine body and cranial vaginal lumen were fluid-filled and contained hyperechoic, polypoid masses that were suspected to be blood clots. Exploratory laparotomy revealed a mildly enlarged uterus with a diffuse, cystic endometrium; significant amounts of blood and blood clots within the lumen; and several focal accumulations of yellow fluid presumed to be a purulent exudate. Histopathology confirmed severe, cystic, endometrial hyperplasia and pyometra complex. PMID:11804322

Troxel, Mark T; Cornetta, Angelyn M; Pastor, Karen F; Hartzband, Lori E; Besancon, Michael F

2002-01-01

341

[Lichen sclerosus--a neglected disease].  

PubMed

We present a small review of lichen sclerosus in women and an update on the newest knowledge, e.g. on calcineurin inhibitors as a choice of treatment. The goal is to put more focus on the disease in Denmark because it is so often diagnosed only with a great delay. We further emphasize the importance of follow-up on these patients, due to the risk of cancer, the great influence of the disease on quality of life and the risk of structural changes in the vulva region. PMID:22094215

Sander, Bente Braad; Damsgaard, Knud

2011-11-14

342

Resection and Reconstruction of Maxillary Class IIIc Defect in a Case of Adenoid Cystic Carcinoma: Cost-Sensitive Technique without Microvascular Grafts  

PubMed Central

ACC is a rare malignant tumor that affects most commonly the major and minor salivary glands and rarely the paranasal sinuses, lacrimal gland, larynx, ear, vulva, and so forth. The maxillary sinus when affected is considered having a poor prognosis due to delayed diagnosis and delayed treatment credited to its slow spread, late symptoms, and complex anatomy which hampers surgical resection. The expressions of tumor markers too have a significant role in determining the prognosis. The treatment of choice consists of wide radical resection of the tumor followed by radiotherapy. Rehabilitation options in cases with huge maxillary defects still need further exploration. PMID:24069539

Adwani, Dwarkadas; Arora, Rajender Singh; Soni, Ramawatar; Adwani, Nitin

2013-01-01

343

Resection and Reconstruction of Maxillary Class IIIc Defect in a Case of Adenoid Cystic Carcinoma: Cost-Sensitive Technique without Microvascular Grafts.  

PubMed

ACC is a rare malignant tumor that affects most commonly the major and minor salivary glands and rarely the paranasal sinuses, lacrimal gland, larynx, ear, vulva, and so forth. The maxillary sinus when affected is considered having a poor prognosis due to delayed diagnosis and delayed treatment credited to its slow spread, late symptoms, and complex anatomy which hampers surgical resection. The expressions of tumor markers too have a significant role in determining the prognosis. The treatment of choice consists of wide radical resection of the tumor followed by radiotherapy. Rehabilitation options in cases with huge maxillary defects still need further exploration. PMID:24069539

Adwani, Dwarkadas; Bhattacharya, Anirudh; Arora, Rajender Singh; Soni, Ramawatar; Adwani, Nitin

2013-01-01

344

Vulvar Langerhans cell histiocytosis: a case report  

PubMed Central

Langerhans cell histiocytoses (LCH) are a rare group of disorders that comprise a large spectrum of diseases initially known as histiocytosis X. In this case report, we relate a case of LCH affecting the vulva of a 47-year-old female. The patient presented since 3 years with a vulvar lesion characterized by non-healing ulcers and a perineal granuloma on which she underwent surgery. Professionals should keep in mind not to treat straightforwardly lesions of the genital tract as simple sexually transmitted diseases. Chronic, atypical genital lesions seen in women need to be worked up and dealt with accordingly. PMID:25404979

Khoummane, Nadia; Guimeya, Cyriane; Lipombi, Dominique; Gielen, François

2014-01-01

345

Acquired Vulvar Lymphangioma Circumscriptum  

PubMed Central

Lymphangioma circumscriptum (LC) is a benign dilation of lymph channels localized to the skin and subcutaneous tissues. It is generally localized in mouth mucosa, tongue, proximal regions of arms and legs, groin, axilla, and trunk. Primary vulvar involvement is very rare. Vulvar involvement occurs in various clinical settings. Here, two uncommon cases with giant lymphangioma circumscriptum mimicking genital warts will be presented: a 55-year-old female patient with extensive lymphangiectasic lesions and genital wart-like papular lesions in the vulva secondary to diffuse scrofuloderma scars and a 60-year-old female patient with verruca-like lesions secondary to chronic inflammation. PMID:24396614

Uçmak, Derya; Aytekin, Sema; Sula, Bilal; Akkurt, Zeynep Meltem; Türkçü, Gül; A?açayak, Elif

2013-01-01

346

Hysteroscopy and episiotomy in a rescued, cold-stressed Florida manatee (Trichechus manatus latirostris) for diagnosis and treatment of a retained fetal skeleton.  

PubMed

A rescued female manatee was observed expelling a fetal bone from the vulva. The manatee was anesthetized and diagnosed with uterine retention of a fetal skeleton by ultrasound and hysteroscopy. Episiotomy was performed to gain manual access to the vagina and uterus for removal of the skeleton. Second intention healing of the episiotomy site produced excellent results. Rescued female manatees should receive a thorough reproductive tract evaluation since presence of retained fetal tissues might not be evident in blood or hormone analyses. Retention of a whole or partial dead fetus can be life-threatening to manatees, and retained tissues should be removed as early as possible. PMID:23082540

Hall, Natalie H; Walsh, Mike; DeLuca, Catherine; Bukoski, Alex

2012-09-01

347

Panic attacks mistaken for relapse of epilepsy.  

PubMed

Panic attacks, a frequent type of pseudoepileptic seizures, occur more frequently in epilepsy patients than in the general population and are often misdiagnosed, leading to pseudosevere epilepsy. We evaluated 4 patients with a past history of epileptic seizures long in remission who were misdiagnosed as having relapsing seizures although they had fairly typical panic attacks. To avoid unnecessary and ineffective antiepileptic drug (AED) treatment, recurrence of seizures after long remission should be carefully evaluated to identify patients with a panic disorder who require specific treatment. In patients who unexpectedly exhibit seizures after long remission, an accurate retrospective diagnosis of the epileptic syndrome and a precise description of the attack symptomatology should be obtained, if possible with EEG-video monitoring. PMID:8001508

Genton, P; Bartolomei, F; Guerrini, R

1995-01-01

348

Diagnosing the bladder as the source of pelvic pain: successful treatment for adults and children.  

PubMed

The key to successful therapy of interstitial cystitis (IC) is to correctly diagnose it. The significant majority of patients with IC have a dysfunctional bladder epithelium that allows urinary solutes (primarily potassium) to leak into the bladder wall, causing symptoms and tissue damage. Drugs that correct this dysfunction and suppress symptoms are important to achieve successful outcomes in patients. Today over 95% of females with IC are misdiagnosed as having gynecologic chronic pelvic pain, vulvodynia, vaginitis, endometriosis, overactive bladder or urinary tract infection. Men are misdiagnosed as having prostatitis. Often children are not diagnosed at all. Multimodal drug therapy may be required and can achieve successful resolution of IC in over 90% of patients. IC in children can be treated successfully with pentosan polysulfate. PMID:25300387

Parsons, C Lowell

2014-07-01

349

Lateral ventricular cystic meningioma: 2 rare case reports  

PubMed Central

Cystic meningioma is an uncommon meningioma variant that is often difficult to distinguish from other intra-axial tumors, including necrotic gliomas. Cystic meningiomas located in the ventricle are particularly rare and may be misdiagnosed with other brain tumors, including ependymoma, choroid plexus papilloma and neurocytoma, due to its location. The present study discusses two cases of lateral ventricular meningiomas, which exhibited intratumoral or peritumoral cystic changes on magnetic resonance imaging scans. The two patients underwent surgical treatment and histological examination confirmed one case of metaplastic meningioma and the other case of psammomatous meningioma. The two patients were middle-aged females and had been misdiagnosed prior to surgery. Although this clinical entity is rare, the diagnosis of meningioma should be considered, particularly in middle-aged female patients. PMID:24940445

QIU, LI-HUA; LUI, SU; ZOU, LING; YUE, QIANG; GONG, QI-YONG

2014-01-01

350

Cervical lymph node sarcoidosis mimicking a parathyroid adenoma: a clinical case.  

PubMed

We report a case of cervical lymph node sarcoidosis misdiagnosed as parathyroid adenoma. This is the second case described in the literature in which lymph node sarcoidosis was misdiagnosed as parathyroid adenoma on Tc-99m sestamibi (MIBI) scan, the first case localized in the neck. A 64-year-old woman presented with a hypercalcemia. Neck ultrasonography revealed a paratracheal hypoechoic mass of 15 mm with peripheral vascularization. MIBI scan and SPECT/CT identified a MIBI-positive area corresponding to the nodule detected by ultrasonography suggestive for a lower right parathyroid adenoma. A mass interpreted as the lower parathyroid was excised associated to a total thyroidectomy. Pathologic examination revealed a granulomatous lymph node consistent with active sarcoidosis. Sarcoidosis should be suspected as a cause of unexplained hypercalcemia and the differential diagnosis of hypercalcemia, even in presence of MIBI uptake, must include sarcoidosis localized in an isolated cervical lymph node. PMID:24250238

Calò, Pietro Giorgio; Pisano, Giuseppe; Tatti, Alberto; Loi, Giulia; Furcas, Silvia; Nicolosi, Angelo

2013-01-01

351

Diagnosis and Conservative Treatment of Extraoral Submental Sinus Tract of Endodontic Origin: A Case Report  

PubMed Central

Sinus tracts (or fistulas) are a common manifestation of pulpal necrosis that requires conventional -or rarely surgical- endodontic treatment in order to heal. They are mainly identified intraorally and in rare cases they manifestate extraorally, depending on the causative tooth, root location, bone thickness and muscle inserts. Such conditions may be misdiagnosed and confused with other non-pulpal pathologies. A case of extra-oral submental sinus tract that was initially misdiagnosed by a physician as a non-odontogenic lesion is presented. Facial fistulas of endodontic origin, despite sparse, should be considered as an option in the differential diagnosis procedure. It is important that interaction occurs between physicians and dentists to avoid exposing patients to insufficient treatment schemes. PMID:25478461

Farmakis, Eleftherios-Terry R

2014-01-01

352

Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess  

PubMed Central

Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain. PMID:25580335

Alqahtani, Saad M.; Gdalevitch, Marie

2014-01-01

353

Dental infection simulating skin lesion.  

PubMed

Orocutaneous fistulas or cutaneous sinus, a tract of dental origin, is an uncommon but well-documented condition that usually requires emergency treatment. Such condition may be misdiagnosed by physicians and dentists and may sometimes be confused with bone and skin tumor, osteomyelitis, congenital fistula, salivary gland fistula, pyogenic granuloma, infected cyst, deep mycotic infection, and other pathologies. A case of facial sinus tract that was initially misdiagnosed by a physician as a nonodontogenic lesion is presented. Nonsurgical endodontic therapy was the treatment of choice for this case. Facial cutaneous sinus tracts must be considered of dental origin. Early diagnosis and prompt treatment minimize patient discomfort and esthetic problems, reducing the possibility of further complications such as sepsis and osteomyelitis. PMID:22892779

Abuabara, Allan; Schramm, Celso Alfredo; Zielak, João César; Baratto-Filho, Flares

2012-01-01

354

Recurrent variceal bleeding in a young woman.  

PubMed

Congenital hepatic fibrosis is an uncommon fibrocystic disorder affecting the intrahepatic bile ducts. It has autosomal recessive inheritance. The main consequence of this condition is portal hypertension and it is often misdiagnosed as cirrhosis. Patients with congenital hepatic fibrosis usually present during childhood or early adolescence with oesophageal variceal bleeding. Portosystemic shunt surgery is the treatment of choice for these patients as the risk of postoperative hepatic encephalopathy is low. We report a patient with congenital hepatic fibrosis who presented with oesophageal variceal bleeding at the age of 16 years, initially misdiagnosed as having cryptogenic liver cirrhosis. The patient experienced two further episodes of oesophageal variceal bleeding in subsequent years. She eventually underwent portosystemic shunt surgery. One year after the operation, the shunt remained patent on Doppler ultrasonography, and there had been no further episodes of variceal bleeding post-surgery. PMID:16085947

Leung, V K S; Loke, T K L; Luk, I S C; Lui, P C W; Kung, N N S; Lam, S H

2005-08-01

355

Dermoscopy findings of hidroacanthoma simplex.  

PubMed

Hidroacanthoma simplex (HAS), also known as intraepidermal eccrine poroma, is a rare eccrine adnexal tumor that tends to be misdiagnosed as other types of benign skin tumor, including clonal seborrheic keratosis. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the later development of porocarcinoma. Therefore, accurate diagnosis of HAS is indispensable for dermatologists to avoid the development of malignant tumors by an unsuitable treatment. In this report, we present the characteristic dermoscopy findings of HAS. Indeed, the dermoscopy findings might be related to the melanin-rich necrotic cells in the epidermis, which are quite different from dermoscopy findings of clonal seborrheic keratosis. As a previous report suggested, it is difficult for a dermatologist to differentiate HAS from clonal seborrheic keratosis by the naked eye. Our findings might be supportive for the early diagnosis of HAS. PMID:24987351

Sato, Yota; Fujimura, Taku; Tamabuchi, Erika; Haga, Takahiro; Aiba, Setsuya

2014-05-01

356

Cervical Lymph Node Sarcoidosis Mimicking a Parathyroid Adenoma: A Clinical Case  

PubMed Central

We report a case of cervical lymph node sarcoidosis misdiagnosed as parathyroid adenoma. This is the second case described in the literature in which lymph node sarcoidosis was misdiagnosed as parathyroid adenoma on Tc-99m sestamibi (MIBI) scan, the first case localized in the neck. A 64-year-old woman presented with a hypercalcemia. Neck ultrasonography revealed a paratracheal hypoechoic mass of 15 mm with peripheral vascularization. MIBI scan and SPECT/CT identified a MIBI-positive area corresponding to the nodule detected by ultrasonography suggestive for a lower right parathyroid adenoma. A mass interpreted as the lower parathyroid was excised associated to a total thyroidectomy. Pathologic examination revealed a granulomatous lymph node consistent with active sarcoidosis. Sarcoidosis should be suspected as a cause of unexplained hypercalcemia and the differential diagnosis of hypercalcemia, even in presence of MIBI uptake, must include sarcoidosis localized in an isolated cervical lymph node. PMID:24250238

Calò, Pietro Giorgio; Pisano, Giuseppe; Tatti, Alberto; Loi, Giulia; Furcas, Silvia; Nicolosi, Angelo

2013-01-01

357

Dermoscopy Findings of Hidroacanthoma Simplex  

PubMed Central

Hidroacanthoma simplex (HAS), also known as intraepidermal eccrine poroma, is a rare eccrine adnexal tumor that tends to be misdiagnosed as other types of benign skin tumor, including clonal seborrheic keratosis. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the later development of porocarcinoma. Therefore, accurate diagnosis of HAS is indispensable for dermatologists to avoid the development of malignant tumors by an unsuitable treatment. In this report, we present the characteristic dermoscopy findings of HAS. Indeed, the dermoscopy findings might be related to the melanin-rich necrotic cells in the epidermis, which are quite different from dermoscopy findings of clonal seborrheic keratosis. As a previous report suggested, it is difficult for a dermatologist to differentiate HAS from clonal seborrheic keratosis by the naked eye. Our findings might be supportive for the early diagnosis of HAS. PMID:24987351

Sato, Yota; Fujimura, Taku; Tamabuchi, Erika; Haga, Takahiro; Aiba, Setsuya

2014-01-01

358

Granulocytic sarcoma of the male breast in acute myeloblastic leukemia with concurrent deletion of 5q and trisomy 8.  

PubMed

We describe a unique case of Granulocytic Sarcoma (GS) in a male, who presented to us with a painless right breast mass without any prior history of Leukemia. GS is an extramedullary tumor of myeloproliferative precursors and may involve multiple sites of the body, but involvement of male breast is extremely rare. In the absence of clinical history or hematological abnormality, GS may be misdiagnosed, depending on the degree of myeloid differentiation present within the tumor. Often it is misdiagnosed as lymphoma. Diagnosis is made by finding eosinophilic myelocytes, myeloperoxidase, chloroacetate esterase staining, and lysozyme immunostain. Chemotherapy regimens similar to acute myeloid leukemia are recommended to treat GS. Recognition of this rare entity is important because early, aggressive chemotherapy can induce regression of the tumor and improve patient longevity. PMID:22937319

Rizwan, Muhammad; Islam, Md Monirul; Rehman, Zia Ur

2012-01-01

359

IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel  

Microsoft Academic Search

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that selectively affects optic nerves and spinal cord. It is considered a severe variant of multiple sclerosis (MS), and frequently is misdiagnosed as MS, but prognosis and optimal treatments differ. A serum immunoglobulin G autoantibody (NMO-IgG) serves as a specific marker for NMO. Here we show that NMO-IgG binds selectively to the

Vanda A. Lennon; Thomas J. Kryzer; Sean J. Pittock; A. S. Verkman; Shannon R. Hinson

2005-01-01

360

Echinococcus granulosus cattle strain identification in an autochthonous case of cystic echinococcosis in central Mexico  

Microsoft Academic Search

Echinococcosis is a frequent hepatic parasitic disease in several countries but it is practically absent in Mexico. A cattle strain of Echinococcus granulosus was identified by RAPD, PCR-RFLP and mitochondrial CO1 gene analysis in an autochthonous case. The parasite was obtained after a laparoscopic excision of a liver cyst from a patient that was symptomatic for 6 years but mis-diagnosed

Pablo Maravilla; R. C. Andrew Thompson; Jose Antonio Palacios-Ruiz; Annika Estcourt; Eduardo Ramirez-Solis; Carmen Mondragon-de-la-Peña; Marcial Moreno-Moller; Alexander Cardenas-Mejia; Pilar Mata-Miranda; Maria-Teresa Aguirre-Alcantara; Carlos Bonilla-Rodriguez; Ana Flisser

2004-01-01

361

[Animal mite-induced epizoonoses and their significance in dermatology].  

PubMed

Different mite species may infest humans temporarily; such arthropods should be considered a possible cause of pruritic skin reactions of unclear origin. Pseudo-scabies is a common problem. This self-limiting dermatosis may often be misdiagnosed. Several mite species including Sarcoptes scabiei var. canis, Sarcoptes scabiei var. bovis, Notoedres cati, Cheyletiella yasguri, Cheyletiella blakei, Dermanyssus gallinae and Ophionyssus natricis may infest human skin, causing symptoms. Other less common animal mites, Neotrombicula autumnalis and foodstuff mites are also discussed. PMID:9036121

Beck, W

1996-10-01

362

Rupture of the right hemidiaphragm due to blunt trauma  

SciTech Connect

Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan with contrast, and intraperitoneal Tc sulfur colloid is suggested for patients with suspected right diaphragmatic trauma.

Leaman, P.L.

1983-06-01

363

Hypocretinergic dysfunction in neuromyelitis optica with coma-like episodes  

PubMed Central

Devic’s neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, often misdiagnosed as multiple sclerosis, and involving mainly optic nerves and the spinal cord. We report on a peculiar case of relapsing NMO with severe recurrent dysautonomia and hypersomnia, in which we had the opportunity to observe a dramatic decrease in hypocretin/orexin cerebrospinal fluid level. PMID:21686670

Carlander, B; Vincent, T; Le Floch, A; Pageot, N; Camu, W; Dauvilliers, Y

2009-01-01

364

Primary malignant rhabdoid tumor of the cerebellum  

Microsoft Academic Search

Malignant rhabdoid tumor (MRT) is a recently described variety of childhood renal neoplasm. MRT arising primarily in the\\u000a central nervous system (CNS) is still a rather unfamiliar pathological entity and is frequently misdiagnosed as medulloblastoma\\u000a or primitive neuroectodermal tumor (PNET). We describe a 7-month-old boy who harbored a CNS-MRT that originated within the\\u000a IV ventricle and invaded the brain stem

Juan F. Martínez-Lage; Andrés Nieto; Joaquín Sola; Rosario Domingo; Trinidad R. Costa; Máximo Poza

1997-01-01

365

Acute ECG ST-segment elevation mimicking myocardial infarction in a patient with pulmonary embolism  

PubMed Central

Pulmonary embolism is a common cardiovascular emergency, but it is still often misdiagnosed due to its unspecific clinical symptoms. Elevated troponin concentrations are associated with greater morbidity and mortality in patients with pulmonary embolism. Right ventricular ischemia due to increased right ventricular afterload is believed to be underlying mechanism of elevated troponin values in acute pulmonary embolism, but a paradoxical coronary artery embolism through opened intra-artrial communication is another possible explanation as shown in our case report. PMID:21106090

2010-01-01

366

Diagnostic Odyssey of a Cutaneous Mycobacteriosis Rare in Central Europe  

Microsoft Academic Search

Cutaneous infection with Mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs

Tobias W. Fischer; Sentayehu Assefa; Heike I. Bauer; Tim Graefe; Matthias Scholz; Wolfgang Pfister; Ute Barta; Uwe Wollina; Peter Elsner

2002-01-01

367

Self-medication for infants with colic in Lagos, Nigeria  

Microsoft Academic Search

BACKGROUND: Infantile colic is a self-limiting condition that is distributed worldwide. It is often misdiagnosed as an organic disease for which an infant is admitted to the hospital. Many studies have described the aetiopathogenesis, pharmacologic and non-pharmacologic management of colic but none has evaluated self-medication for infants with colic. The aim of this study was therefore to determine the knowledge

Kazeem A Oshikoya; Idowu O Senbanjo; Olisamedua F Njokanma

2009-01-01

368

Three-dimensional power Doppler sonography in the diagnosis of a cystic sacrococcygeal teratoma mimicking a meningomyelocele: A case report.  

PubMed

Sacrococcygeal teratomas have been diagnosed prenatally on sonograms as masses of cystic, solid, or mixed echogenicity from the sacral area and protruding through the perineum or buttocks. However, a cystic sacrococcygeal teratoma may be misdiagnosed as an anterior sacral meningomyelocele, especially when presenting as a posterior cystic mass. We report a case in which three-dimensional power Doppler imaging was helpful for making a correct prenatal diagnosis of a type 1 cystic sacrococcygeal teratoma, which mimicked a meningomyelocele. PMID:19484739

Sugitani, Maiko; Morokuma, Seiichi; Hidaka, Nobuhiro; Kinoshita, Yoshiaki; Taguchi, Tomoaki; Tsukimori, Kiyomi; Wake, Norio

2009-09-01

369

Isolated subpulmonic fibrous ring, mirror-image dextrocardia and situs solitus in a young lady unreported and a near miss  

PubMed Central

Congenital diseases causing obstruction of the right ventricular outflow tract (RVOT) are common, but the isolated subpulmonary membrane/ring is extremely rare and can be difficult to diagnose precisely, especially in adults. We report a case of surgically resected isolated subpulmonic fibrous ring in a lady with mirror-image dextrocardia and abdominal situs solitus that was misdiagnosed by echocardiography as a subaortic membrane. PMID:23962853

Yousif, Musaab; Elhassan, Nezar B.; Ali, Sulafa K.M.; Ahmed, Yassir

2013-01-01

370

Genitogluteal porokeratosis - Case report*  

PubMed Central

We report the case of a patient diagnosed with genitogluteal porokeratosis, a disorder of epidermal keratinization. The location described is extremely rare and very often late diagnosed or even misdiagnosed. Histopathology showed a typical cornoid lamella of great value to support this diagnosis. The importance of awareness of this entity by the specialist is emphasized as a differential diagnosis among genital diseases of chronic evolution and difficult treatment. PMID:23793197

Ferreira, Flávia Regina; Lessa, Priscila Pacheco; de Alvarenga, Marcia Lanzoni

2013-01-01

371

The natural history of primary temporal bone myxoma.  

PubMed

Primary myxomas of the temporal bone are rare tumors. If misdiagnosed, they can grow into locally aggressive expansile masses resulting in hearing loss, facial paralysis, dural invasion, and mass effect on the adjacent brain parenchyma. This case demonstrates the natural history of an extraordinarily rare tumor over a longer period not previously described. The importance of correlating histopathologic findings with diagnostic imaging features to enable an accurate diagnosis is also emphasized. PMID:22483549

Guha-Thakurta, Nandita; Deavers, Michael; DeMonte, Franco; Gidley, Paul W

2012-08-01

372

Acute epiploic appendagitis: CT findings in 33 cases  

Microsoft Academic Search

.   Acute epiploic appendagitis (AEA) is a benign self-limiting process presenting with acute abdominal pain often misdiagnosed\\u000a clinically as either diverticulitis or appendicitis, but which has a pathognomonic CT appearance. The CT findings in 33 adult\\u000a patients diagnosed by CT over a 33-month period as having AEA were retrospectively reviewed. The study group included 24 men\\u000a and 9 women, with

Rivka Zissin; Marjorie Hertz; Alexandra Osadchy; Eugene Kots; Myra Shapiro-Feinberg; Haim Paran

2002-01-01

373

Cutaneous Lymphadenoma: A Rare Case and Brief Review of a Diagnostic Pitfall  

PubMed Central

We report a case of cutaneous lymphadenoma on the posterior left ear of a 67-year-old woman. Although it is benign, recognition of cutaneous lymphadenoma is important as it presents a diagnostic pitfall to the unsuspecting dermatologist and general surgical pathologist, who may readily misdiagnose the lesion because it is not only very rare, but also clinically and histologically resembles the far more common and locally destructive basal cell carcinoma. PMID:25002949

Yu, Ryan; Salama, Samih; Alowami, Salem

2014-01-01

374

Enduring Fluoride Health Hazard for the Vesuvius Area Population: The Case of AD 79 Herculaneum  

Microsoft Academic Search

BackgroundThe study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological lesions. Even today its early stages are misdiagnosed in endemic areas.Methodology\\/Principal

Pierpaolo Petrone; Michele Giordano; Stefano Giustino; Fabio M. Guarino

2011-01-01

375

Evaluation of Three Techniques for Detection of Low-Level Methicillin-Resistant Staphylococcus aureus (MRSA): a Disk Diffusion Method with Cefoxitin and Moxalactam, the Vitek 2 System, and the MRSA-Screen Latex Agglutination Test  

Microsoft Academic Search

Very-low-level methicillin-resistant Staphylococcus aureus (MRSA), or class 1 MRSA, is often misdiagnosed as methicillin-susceptible S. aureus (MSSA). We evaluated the performances of three methods for detection of low-level methicillin resistance: the disk diffusion method using the cephamycin antibiotics cefoxitin and moxalactam, the Vitek 2 system (bioMerieux), and the MRSA-screen test (Denka). Detection of the mecA gene by PCR was considered

Annie Felten; Bernadette Grandry; Philippe Henri Lagrange; Isabelle Casin

2002-01-01

376

Emergency Sleeve Gastrectomy as Rescue Treatment for Acute Gastric Necrosis Due to Type II Paraesophageal Hernia in an Obese Woman with Gastric Banding  

Microsoft Academic Search

A morbidly obese 42-year-old woman presented with a 1-week history of left chest pain. She had undergone laparoscopic adjustable\\u000a gastric banding 16 months earlier with a body mass index (BMI) of 49.2 kg\\/m2. Diagnostic workup revealed a large left pleural empyema and ruled out band slippage. At left thoracotomy, a misdiagnosed\\u000a type II paraesophageal strangulated hernia with gastric necrosis and large perforation

Paolo Bernante; Cristiano Breda; Fabio Zangrandi; Fabio Pomerri; Maria Rosa Pelizzo; Mirto Foletto

2008-01-01

377

Multiple Aortic Operations in Loeys-Dietz Syndrome: Report of 2 Cases  

PubMed Central

Due to its low prevalence and because there is lack of awareness about it, Loeys-Dietz syndrome is often mis-diagnosed as Marfan syndrome, which has similar skeletal abnormalities and aortic pathology. However, the differential diagnosis between these two connective tissue diseases is critical because they correspond to different surgical indications and surgical decision-making. We report two cases of successful thoracoabdominal aortic replacement in patients with previously undiagnosed Loeys-Dietz syndrome. PMID:25551076

Na, Kwon Joong; Park, Kay-Hyun

2014-01-01

378

Reconstruction of an unusual orocutaneous fistula by using a bilobed flap.  

PubMed

Orocutaneous fistulas or cutaneous sinus tracts of dental origin are pathologic communications between the cutaneous surface of the face and the oral cavity. They are relatively uncommon and may be easily misdiagnosed. In this report, management of an orocutaneous fistula of dental origin, which endured for 20 years, by using an extraoral bilobed skin flap, an intraoral buccal rotational mucosal flap and allogenic bone graft, is presented. PMID:19092756

Dolanmaz, D; Kucukkolbasi, H; Isik, K

2008-01-01

379

Traumatic atlantoaxial rotatory fixation associated with C2 articular facet fracture in adult patient: Case report  

PubMed Central

Traumatic atlantoaxial rotatory fixation is a very rare injury in adults which is often misdiagnosed initially. Its combination with C2 fractures is predominated by dens lesions. Therapeutic management is challenging because of the difficulty to achieve optimal reduction and permanent stability. We report a rare case of traumatic atlantoaxial rotatory fixation in a 56-year-old women associated with C2 articular facet fracture successfully treated by conservative means after patient-awake manual reduction with optimal functional and radiographic outcome.

Bellil, Mehdi; Hadhri, Khaled; Sridi, Maamoun; Kooli, Mondher

2014-01-01

380

Thyrotoxic psychosis in an elderly woman and haloperidol use: a case report.  

PubMed

Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61-year-old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state. PMID:23551412

Emul, Murat; Sakalli, Ayse; Erol, Turgut Can; Ertan, Turan

2013-03-01

381

Three Different Dermoscopic View of Three New Cases with Pilomatrixoma  

PubMed Central

Pilomatrixoma is a benign soft tissue neoplasm originated from follicular matrix of hair and is also known as Malherbe's calcified epithelioma. Some lesions are located on the skin and are usually misdiagnosed. A small number of patients had been dermoscopically examined. In this article, three patients of pilomatrixoma who had three different dermoscopic views were evaluated and discussed in concordance with the literature. PMID:25114449

Ayhan, Erhan; Ertugay, OC; Gundogdu, R

2014-01-01

382

Primary thymic carcinoid with Cushing's syndrome  

Microsoft Academic Search

Summary  In a 52-year-old Caucasian man osteopoikilosis had been misdiagnosed roentgenologically 2 years before his death. Gradually\\u000a he developed Cushing's syndrome and ultimately superior vena caval obstruction. At autopsy a primary thymic carcinoid with\\u000a extensive osteoblastic bone metastasis was found. Immunohistochemically the tumor was shown to be positive for adrenocorticotropic\\u000a hormone (ACTH), cytokeratin (KL1), neuron-specific enolase, synaptophysin, chromogranin and glucagon. Remarkably

Gregor Wollensak; Eberhard Walter Herbst; Andreas Beck; Hans-Eckart Schaefer

1992-01-01

383

Solitary Pilar Leiomyoma of the Nasal Dorsum: Case Report and Literature Review  

PubMed Central

Cutaneous leiomyoma is an infrequently occurring benign tumor that arises from smooth muscle in the skin. Pilar leiomyoma, a subtype of cutaneous leiomyoma, arises from the arrector pili muscle associated with hair follicles. Pilar leiomyoma, particularly in the head and neck region, is rare and frequently misdiagnosed. We report one patient who developed pilar leiomyoma of the nasal dorsum, explore the differential diagnosis and review the characteristics of previously reported individuals with pilar leiomyoma of the nasal dorsum.

Hoyt, Brian S; Tschen, Jaime A; Cohen, Philip R

2015-01-01

384

Retinoblastoma in Adults: a Case Report and Literature Review  

PubMed Central

Purpose: To report a case of adult retinoblastoma with a wrong diagnosis of melanoma. Case report: Herein, we present an adult retinoblastoma case who was misdiagnosed as melanoma in fine-needle aspiration biopsy with intravitreal hemorrhage and later neovascular glaucoma after biopsy. The diagnosis of retinoblastoma was confirmed after enucleation. Conclusion: Retinoblastoma should be considered in the differential diagnosis of an intraocular mass in adults, especially when media haziness precludes adequate ophthalmoscopic visualization.

Sharifzadeh, Mehdi; Ghassemi, Fariba; Amoli, Fahimeh Asadi; Rahmanikhah, Elham; Tabatabaie, Seid Zia

2014-01-01

385

Surgical management of peripheral variant of adenomatoid odontogenic tumor: A rare case report with review  

PubMed Central

The adenomatoid odontogenic tumour (AOT) is a relatively uncommon lesion constituting around 3% of all odontogenic tumours and often misdiagnosed as an odontogenic cyst. It manifests as a beningn growth which affects young individuals, with a female predeliction usually in the second decade of life, exhibiting more often in the anterior region of maxilla. The current article enumerates the clinical, radiographic and histopathological features of a rare case of extraosseous AOT with its therapeutic consideration

Jindwani, Karuna; Paharia, Y. K.; Kushwah, Atul Pratap Singh

2015-01-01

386

Microcystic adnexal carcinoma: review of a potential diagnostic pitfall and management.  

PubMed

Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive cutaneous neoplasm that usually presents as a slow-growing, asymptomatic lesion on the head or neck. Microcystic adnexal carcinoma frequently is misdiagnosed due to its histologic appearance on superficial biopsy specimens mimicking other follicular neoplasms. Herein, we highlight a case in which a slow-growing lesion was initially diagnosed as a trichoadenoma following superficial biopsy; however, after surgical excision the pathology revealed a locally aggressive MAC. PMID:24738099

McKinley, Lana H; Seastrom, Stacey; Hanly, Andrew J; Miller, Richard A

2014-03-01

387

Subungual osteochondroma: a diagnostic dilemma.  

PubMed

Osteochondroma is the most common skeletal neoplasm of all benign bone tumors. However, it rarely occurs subungually. In this location, the lesion may penetrate the skin, causing nail deformity, and can easily be misdiagnosed. We report two cases of subungual osteochondroma of the distal phalanges of the first toes with cutaneous penetration and discuss the clinical, histologic, and radiographic features and the treatment options. PMID:16546954

Tuzuner, Tolga; Kavak, Ayse; Parlak, Ali Haydar; Ustundag, Nil

2006-01-01

388

[Anti-fungal resistant hypopigmented macules in an adolescent].  

PubMed

Progressive macular hypomelanosis of the trunk is a disease of unknown origin that often goes unrecognized in the clinical setting. We present an adolescent with this condition initially diagnosed as tinea versicolor. She was asymptomatic, with hypopigmented macules located on the trunk and with no previous history of inflammation, infection or injury. Progressive macular hypomelanosis is a common disorder that has frequently been misdiagnosed, probably because it is often considered a post-inflammatory hypopigmentation or pityriasis versicolor. PMID:22935838

Martínez Martínez, M L; Azaña Defez, J M; López Villaescusa, M T; Gómez Sánchez, M

2012-09-01

389

A Case of Reed's Syndrome: An Underdiagnosed Tumor Disorder  

PubMed Central

Cutaneous leiomyomas are uncommon, benign smooth muscle tumors originating from the arrector pili muscle of the hair follicle that are frequently unrecognized and underdiagnosed by clinicians. They sometimes coexist with common uterine fibroids in an inherited disorder named multiple cutaneous and uterine leiomyomatosis, also referred to as Reed's syndrome. We report a case of Reed's syndrome in a young woman who had been misdiagnosed for many years. PMID:25232316

Kontochristopoulos, Georgios; Kouris, Anargyros; Balamoti, Evgenia; Vavouli, Charitomeni; Markantoni, Vasiliki; Christofidou, Elefteria; Antoniou, Christina

2014-01-01

390

Lime-induced phytophotodermatitis  

PubMed Central

This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

2014-01-01

391

Subcutaneous emphysema of the lower extremity of gastrointestinal orgin  

Microsoft Academic Search

Summary  Two cases of subcutaneous emphysema of the left lower extremity secondary to perforations of the rectum and sigmoid colon\\u000a are presented. Although this is an extremely rare syndrome, the true incidence is probably higher, as some cases will be misdiagnosed\\u000a as gas gangrene unless careful clinical and postmortem examinations are performed.\\u000a \\u000a Only rapid recognition of the probable origin of the

Thomas A. Fox; Jorge Gomez; Jose Bravo

1978-01-01

392

Acute Legionella pneumophila infection masquerading as acute alcoholic hepatitis  

PubMed Central

A middle-aged man had deteriorated rapidly in hospital after being misdiagnosed with acute alcoholic hepatitis. Acute Legionnaires disease (Legionellosis) was subsequently diagnosed on rapid antigen urinary testing and further confirmed serologically. This led to appropriate antibiotic treatment and complete clinical resolution. Physicians caring for patients with alcohol-related liver disease should consider Legionella pneumophila in their differential diagnosis even with a paucity of respiratory symptoms. PMID:23355576

Hunter, Jonathan Michael; Chan, Julian; Reid, Angeline Louise; Tan, Chistopher

2013-01-01

393

A case of pseudogout of the temporomandibular joint with giant cell reparative granuloma of the temporal bone.  

PubMed

Pseudogout, also known as calcium pyrophosphate dihydrate deposition disease (CPPD) with giant cell reparative granuloma (GCRG) of the temporal bone is a rare disease, which is very easy to misdiagnose. When two diseases occur simultaneously, the pathological tissue of diseases is closely associated, which complicates clinical representation and causes enormous difficulty in diagnosis and treatment. We report a case of CPPD of the temporomandibular joint accompanied by surrounding GCRG of temporal bone in a 62-year-old male. PMID:23969082

Lv, Huaiqing; Fan, Zhaomin; Han, Yuechen; Xu, Lei; Wang, Haibo

2013-01-01

394

Endovascular treatment of vein of Galen dural arteriovenous fistula presenting as dementia.  

PubMed

Dural arteriovenous fistula (DAVF) is an important cause of neurological dysfunction that is often misdiagnosed, especially in elderly population. Galenic DAVFs are a subtype of the rare falcotentorial DAVFs with a high risk of hemorrhage and aggressive clinical course. In most cases, DAVFs present with pulsatile tinnitus, headache, or orbital symptoms such as chemosis and proptosis. We report a patient with DAVF of Vein of Galen presented with progressive dementia, treated by Onyx embolisation and had good clinical outcome. PMID:25506172

Huded, Vikram; Moeed, Syed Zafer; Desouza, Romnesh; Tripathi, Ravikesh; Nair, Rithesh

2014-10-01

395

Multiple aortic operations in loeys-dietz syndrome: report of 2 cases.  

PubMed

Due to its low prevalence and because there is lack of awareness about it, Loeys-Dietz syndrome is often mis-diagnosed as Marfan syndrome, which has similar skeletal abnormalities and aortic pathology. However, the differential diagnosis between these two connective tissue diseases is critical because they correspond to different surgical indications and surgical decision-making. We report two cases of successful thoracoabdominal aortic replacement in patients with previously undiagnosed Loeys-Dietz syndrome. PMID:25551076

Na, Kwon Joong; Park, Kay-Hyun

2014-12-01

396

Dentigerous Cyst or Adenomatoid Odontogenic Tumor: Clinical Radiological and Histopathological Dilemma  

PubMed Central

Adenomatoid odontogenic tumor (AOT) is a well-recognised slow growing benign tumor derived from complex system of dental lamina or its remnants. This lesion is categorised into three variants of which the more common variant is follicular type which is often mistaken for dentigerous cyst. We present a case of AOT in a 14-year-old male who was misdiagnosed as dentigerous cyst. Clinical radiological and therapeutic characteristics of the case are commented on in detail. PMID:25097553

Acharya, Shivesh; Goyal, Ashima; Rattan, Vidya; Vaiphei, Kim; Kaur Bhatia, Sarabjot

2014-01-01

397

Elastotic nodules of the ears.  

PubMed

A case of bilateral elastotic nodules of the ears is reported. This distinctive entity occurs on the ears in response to chronic actinic damage and is seen infrequently. Elastotic nodules of the ears may therefore be misdiagnosed clinically as basal cell carcinoma or some infiltrative process such as gout or amyloid. Although the lesions are usually found on the anthelix, they may also arise on the helix, and can then simulate chondrodermatitis nodularis helicis. PMID:2612205

Requena, L; Aguilar, A; Sánchez Yus, E

1989-12-01

398

DNA diagnosis of pyruvate dehydrogenase deficiency in female patients with congenital lactic acidaemia  

Microsoft Academic Search

Summary  The diagnosis of pyruvate dehydrogenase (PDH) E1? deficiency, which is an X-linked inborn error of metabolism, is usually\\u000a established by the measurement of PDH complex activity in cultured cells. However, heterozygous female patients with PDH E1?\\u000a deficiency may be misdiagnosed when the normal X chromosome is predominantly expressed in the cultured cells. Therefore, in\\u000a female patients with convincing clinical presentations

J. Matsuda; M. Ito; E. Naito; I. Yokota; Y. Kuroda

1995-01-01

399

Challenging diagnosis between intussusception and necrotizing enterocolitis in premature infants.  

PubMed

Although necrotizing enterocolitis (NEC) is a frequently encountered entity in premature infants in the neonatal intensive care unit, intussusception is extremely rare. Abdominal distension, bilious/non-bilious gastric residuals and bloody stool are the common clinical findings of both entities. Here we present three cases of intussusception misdiagnosed as NEC, two of which were complicated with intestinal perforation. Similar clinical findings of NEC and intussusception leads to misdiagnosis and delay in treatment, particularly in premature infants with intussusception. PMID:24894937

Ta?k?nlar, Hakan; Gündo?du, Gökhan; Celik, Yalç?n; Avlan, Dinçer; Nayc?, Ali

2014-06-01

400

Three different dermoscopic view of three new cases with pilomatrixoma.  

PubMed

Pilomatrixoma is a benign soft tissue neoplasm originated from follicular matrix of hair and is also known as Malherbe's calcified epithelioma. Some lesions are located on the skin and are usually misdiagnosed. A small number of patients had been dermoscopically examined. In this article, three patients of pilomatrixoma who had three different dermoscopic views were evaluated and discussed in concordance with the literature. PMID:25114449

Ayhan, Erhan; Ertugay, Oc; Gundogdu, R

2014-01-01

401

Lime-induced phytophotodermatitis.  

PubMed

This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

2014-01-01

402

Neurologic complications of carbon monoxide intoxication.  

PubMed

Carbon monoxide poisoning remains a common neurologic problem as it causes more than one-half of fatal poisonings in many countries leading frequently to acute and delayed brain injury. Mild carbon monoxide intoxication is difficult to diagnose as symptoms can be nonspecific and therefore can be easily misdiagnosed. Common acute and delayed clinical presentations and their associated neuropathology and neuroimaging findings are discussed. Treatment remains limited and outcome is highly variable. PMID:24365364

Betterman, Kerstin; Patel, Surju

2014-01-01

403

Severe Metabolic Bone Disease as a Long-Term Complication of Obesity Surgery  

Microsoft Academic Search

Background: Metabolic bone disease is a well-documented long-term complication of obesity surgery. It is often undiagnosed,\\u000a or misdiagnosed, because of lack of physician and patient awareness. Abnormalities in calcium and vitamin D metabolism begin\\u000a shortly after gastrointestinal bypass operations; however, clinical and biochemical evidence of metabolic bone disease may\\u000a not be detected until many years later. Case Report: A 57-year-old

Whitney S. Goldner; Thomas M. O'Dorisio; Joseph S. Dillon; Edward E. Mason

2002-01-01

404

Peanut Allergy in Children: Relationships to Health-Related Quality of Life, Anxiety, and Parental Stress  

E-print Network

non- medical effects specifically related to peanut allergy. In one such article (Masia et al., 1998) a case study of a seven year old boy was described, who was referred due to symptoms of Obsessive-Compulsive Disorder secondary to a peanut allergy... disorder and allergies in children was found. The authors proposed that, in some cases, food allergy may be initially misdiagnosed as panic disorder, and that their similar symptoms may have contributed to the relationship found in this study. Slattery...

Roy, Kimberlee Marie

2008-07-22

405

Schizoaffective Disorder With Missed Diagnosis of Acute Porphyria: A Case Report and Overview  

PubMed Central

Acute porphyrias are often misdiagnosed and most commonly present as atypical neuropsychiatric symptoms or acute abdominal pain. Clinicians should suspect acute porphyrias in patients presenting with variable neuropsychiatric symptoms and unexplained pain. Proper identification can lead to less iatrogenicity associated with porphyrinogenic agents, appropriate management, and a better patient outcome. The case of a patient with hereditary coproporphyria, one of the acute porphyrias, is presented to illustrate the broad manifestations, unsuspected diagnosis, and difficulties in management. PMID:22454794

Bennett, Jeffrey I.; Resch, David S.; Godwin, John E.

2011-01-01

406

Schizoaffective disorder with missed diagnosis of acute porphyria: a case report and overview.  

PubMed

Acute porphyrias are often misdiagnosed and most commonly present as atypical neuropsychiatric symptoms or acute abdominal pain. Clinicians should suspect acute porphyrias in patients presenting with variable neuropsychiatric symptoms and unexplained pain. Proper identification can lead to less iatrogenicity associated with porphyrinogenic agents, appropriate management, and a better patient outcome. The case of a patient with hereditary coproporphyria, one of the acute porphyrias, is presented to illustrate the broad manifestations, unsuspected diagnosis, and difficulties in management. PMID:22454794

Jain, Gaurav; Bennett, Jeffrey I; Resch, David S; Godwin, John E

2011-01-01

407

Wrist Tenosynovitis due to Mycobacterium bovis Infection: Case Series and Review of the Literature  

PubMed Central

Summary: Tuberculosis infections are still one of the most important public health problems among developing countries. Musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Tuberculosis tenosynovitis is usually misdiagnosed as nonspecific tenosynovitis. To avoid misdiagnosis and mistreatment, it is important to be alert for mycobacterial infections. This article presents 3 patients with wrist tenosynovitis, which was caused by Mycobacterium bovis infection. The article also includes review of the literature. PMID:25587496

Güner, Mehmet Dervi?; Bekta?, Umut; Akme?e, Ramazan; Armangil, Mehmet; Ay, ?adan

2014-01-01

408

Unusual unilateral presentation of pachydermodactyly: a case report  

Microsoft Academic Search

Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal\\u000a interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule,\\u000a clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with\\u000a inflammatory rheumatic diseases, especially with juvenile chronic

Hasan UlusoyNevsun; Nevsun Pihtili Tas; Gurkan Akgol; Arif Gulkesen; Ayhan Kamanli

409

Primary Extracranial Meningiomas: An Analysis of 146 Cases  

Microsoft Academic Search

Primary extracranial meningiomas are rare neoplasms, frequently misdiagnosed, resulting in inappropriate clinical management.\\u000a To date, a large clinicopathologic study has not been reported. One hundred and forty-six cases diagnosed between 1970 and\\u000a 1999 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemistry\\u000a analysis was performed (n = 85), and patient follow-up was obtained (n = 110).

Elisabeth J. Rushing; John-Paul Bouffard; Sherman McCall; Cara Olsen; Hernando Mena; Glenn D. Sandberg; Lester D. R. Thompson

2009-01-01

410

Caution for diagnosis and surgical treatment of recurrent cholangitis: lessons from 5 cases of bile duct tumor thrombus without a detectable intrahepatic tumor.  

PubMed

The hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT) usually have no specific clinical symptoms at early stages. HCC with BDTT was usually misdiagnosed when the intrahepatic tumor was small, even undetectable. In this study, 5 cases of HCC with BDTT misdiagnosed as choledocholithiasis and cholangitis in the local hospital are described. We analyzed retrospectively and summarized our experiences of these 5 HCC patients with BDTT misdiagnosed in the local hospital during the past 5 years. The diagnosis, treatment, and outcome of the patients are discussed. Three patients underwent hepatectomy with thrombectomy and T-tube drainage. One patient underwent hepatectomy with the resection of the common bile duct and hepatojejunostomy, and palliative surgery was performed in 1 patient with portal vein tumor thrombus and intrahepatic metastasis. The patients were followed for 6-22 months; 4 patients died of tumor recurrence and metastasis or hepatic failure, despite 3 of these patients having received transhepatic arterial chemotherapy and embolization or radiofrequency ablation therapy. Early and accurate diagnosis of HCC with BDTT is very important. When patients have a history of abnormal recurrent cholangitis, HCC with BDTT should be highly suspected. Intraductal ultrasonography (US), intraoperative US, and histopathological examination are very valuable for the diagnosis. The prognosis of HCC patients with BDTT is dismal. Identification of this type of patient is clinically important, because surgical treatment may be beneficial. PMID:25192487

Wu, Zheng; Guo, Kun; Sun, Hao; Yu, Liang; Lv, Yi; Wang, Bo

2014-09-01

411

A Cholinergic-Regulated Circuit Coordinates the Maintenance and Bi-Stable States of a Sensory-Motor Behavior during Caenorhabditis elegans Male Copulation  

PubMed Central

Penetration of a male copulatory organ into a suitable mate is a conserved and necessary behavioral step for most terrestrial matings; however, the detailed molecular and cellular mechanisms for this distinct social interaction have not been elucidated in any animal. During mating, the Caenorhabditis elegans male cloaca is maintained over the hermaphrodite's vulva as he attempts to insert his copulatory spicules. Rhythmic spicule thrusts cease when insertion is sensed. Circuit components consisting of sensory/motor neurons and sex muscles for these steps have been previously identified, but it was unclear how their outputs are integrated to generate a coordinated behavior pattern. Here, we show that cholinergic signaling between the cloacal sensory/motor neurons and the posterior sex muscles sustains genital contact between the sexes. Simultaneously, via gap junctions, signaling from these muscles is transmitted to the spicule muscles, thus coupling repeated spicule thrusts with vulval contact. To transit from rhythmic to sustained muscle contraction during penetration, the SPC sensory-motor neurons integrate the signal of spicule's position in the vulva with inputs from the hook and cloacal sensilla. The UNC-103 K+ channel maintains a high excitability threshold in the circuit, so that sustained spicule muscle contraction is not stimulated by fewer inputs. We demonstrate that coordination of sensory inputs and motor outputs used to initiate, maintain, self-monitor, and complete an innate behavior is accomplished via the coupling of a few circuit components. PMID:21423722

Liu, Yishi; LeBeouf, Brigitte; Guo, Xiaoyan; Correa, Paola A.; Gualberto, Daisy G.; Lints, Robyn; Garcia, L. Rene

2011-01-01

412

New species of Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914 (Nematoda) from the gastro-intestinal tract of lizards in Iran.  

PubMed

As part of a faunistic study on helminth parasites of Iranian lizards collected from localities in the north of Isfahan province in Iran, two new nematode species belonging to two different families, Pharyngodonidae Travassos, 1919 and Physalopteroidae Railliet, 1893, were found and are, hereby, described. Spauligodon persiensis n. sp. from the large intestine of Cyrtopodion scabrum Heyden is characterised by its imperceptible lateral alae, lack of spicule, different shape of the genital curtain, position of last pair of papillae, aspinose tail in males, position of the vulva and excretory pore, and a tail filament with six to nine spines in females. Thubunea mobedii n. sp. from the stomach of Laudakia nupta nupta (De Filipi) differs from the other species in the genus by possessing a vulva at level of the posterior portion of the oesophageal-intestinal junction in females, lacking spicules, and having a different number of papillae in males. The present paper provides the results of detailed morphological examination of the two new nematode species, using both light and scanning electron microscopy. Taxonomically important characteristics for the members of the two nematode genera, Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914, are also reviewed. PMID:25301515

Pazoki, Samaneh; Rahimian, Hassan

2014-11-01

413

A cholinergic-regulated circuit coordinates the maintenance and bi-stable states of a sensory-motor behavior during Caenorhabditis elegans male copulation.  

PubMed

Penetration of a male copulatory organ into a suitable mate is a conserved and necessary behavioral step for most terrestrial matings; however, the detailed molecular and cellular mechanisms for this distinct social interaction have not been elucidated in any animal. During mating, the Caenorhabditis elegans male cloaca is maintained over the hermaphrodite's vulva as he attempts to insert his copulatory spicules. Rhythmic spicule thrusts cease when insertion is sensed. Circuit components consisting of sensory/motor neurons and sex muscles for these steps have been previously identified, but it was unclear how their outputs are integrated to generate a coordinated behavior pattern. Here, we show that cholinergic signaling between the cloacal sensory/motor neurons and the posterior sex muscles sustains genital contact between the sexes. Simultaneously, via gap junctions, signaling from these muscles is transmitted to the spicule muscles, thus coupling repeated spicule thrusts with vulval contact. To transit from rhythmic to sustained muscle contraction during penetration, the SPC sensory-motor neurons integrate the signal of spicule's position in the vulva with inputs from the hook and cloacal sensilla. The UNC-103 K(+) channel maintains a high excitability threshold in the circuit, so that sustained spicule muscle contraction is not stimulated by fewer inputs. We demonstrate that coordination of sensory inputs and motor outputs used to initiate, maintain, self-monitor, and complete an innate behavior is accomplished via the coupling of a few circuit components. PMID:21423722

Liu, Yishi; LeBeouf, Brigitte; Guo, Xiaoyan; Correa, Paola A; Gualberto, Daisy G; Lints, Robyn; Garcia, L Rene

2011-03-01

414

Changes in Men’s Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents  

PubMed Central

Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75?min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E.; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

2013-01-01

415

Intraspecific evolution of the intercellular signaling network underlying a robust developmental system  

PubMed Central

Many biological systems produce an invariant output when faced with stochastic or environmental variation. This robustness of system output to variation affecting the underlying process may allow for “cryptic” genetic evolution within the system without change in output. We studied variation of cell fate patterning of Caenorhabditis elegans vulva precursors, a developmental system that relies on a simple intercellular signaling network and yields an invariant output of cell fates and lineages among C. elegans wild isolates. We first investigated the system’s genetic variation in C. elegans by means of genetic tools and cell ablation to break down its buffering mechanisms. We uncovered distinct architectures of quantitative variation along the Ras signaling cascade, including compensatory variation, and differences in cell sensitivity to induction along the anteroposterior axis. In the unperturbed system, we further found variation between isolates in spatio-temporal dynamics of Ras pathway activity, which can explain the phenotypic differences revealed upon perturbation. Finally, the variation mostly affects the signaling pathways in a tissue-specific manner. We thus demonstrate and characterize microevolution of a developmental signaling network. In addition, our results suggest that the vulva genetic screens would have yielded a different mutation spectrum, especially for Wnt pathway mutations, had they been performed in another C. elegans genetic background. PMID:18981482

Milloz, Josselin; Duveau, Fabien; Nuez, Isabelle; Félix, Marie-Anne

2008-01-01

416

C. elegans Dopaminergic D2-Like Receptors Delimit Recurrent Cholinergic-Mediated Motor Programs during a Goal-Oriented Behavior  

PubMed Central

Caenorhabditis elegans male copulation requires coordinated temporal-spatial execution of different motor outputs. During mating, a cloacal circuit consisting of cholinergic sensory-motor neurons and sex muscles maintains the male's position and executes copulatory spicule thrusts at his mate's vulva. However, distinct signaling mechanisms that delimit these behaviors to their proper context are unclear. We found that dopamine (DA) signaling directs copulatory spicule insertion attempts to the hermaphrodite vulva by dampening spurious stimulus-independent sex muscle contractions. From pharmacology and genetic analyses, DA antagonizes stimulatory ACh signaling via the D2-like receptors, DOP-2 and DOP-3, and G?o/i proteins, GOA-1 and GPA-7. Calcium imaging and optogenetics suggest that heightened DA-expressing ray neuron activities coincide with the cholinergic cloacal ganglia function during spicule insertion attempts. D2-like receptor signaling also attenuates the excitability of additional mating circuits to reduce the duration of mating attempts with unproductive and/or inappropriate partners. This suggests that, during wild-type mating, simultaneous DA-ACh signaling modulates the activity threshold of repetitive motor programs, thus confining the behavior to the proper situational context. PMID:23166505

Correa, Paola; LeBoeuf, Brigitte; García, L. René

2012-01-01

417

Description of Meloidoderita polygoni n. sp. (Nematoda: Meloidoderitidae) from USA and Observations on M. kirjanovae from Israel and USSR.  

PubMed

Meloidoderita polygoni n. sp. is described and illustrated from roots of smartweed (Polygonum hydropiperoides) from Beltsville, Maryland. This new species is similar to M. kirjanovae but differs especially in having larger spines on the cystoid bodies, females with the anus much closer to the vulva, and more posterior excretory pore. M. polygoni differs from M. safrica particularly in having females with a shorter stylet, a DGO much closer to base of stylet, greater distance between vulva and anus, and larger cystoid bodies. LM and SEM observations showed only three incisures in lateral fields of juveniles and males and no bursa in males. Morphometric data and illustrations are given for M. kirjanovae from mint (Mentha longifolia) in Israel and some details on a limited number of specimens from Armenian SSR. LM examination of juveniles from both these areas indicated only three incisures in lateral fields. Males from Israel had no detectable bursa and appeared to have only three incisures in lateral fields. (Males from Armenian SSR not observed.). PMID:19294022

Golden, A M; Handoo, Z A

1984-07-01

418

Patients with usual vulvar intraepithelial neoplasia-related vulvar cancer have an increased risk of cervical abnormalities  

PubMed Central

Background: Vulvar squamous cell carcinoma (SCC) originates the following two pathways, related to differentiated (d) vulvar intraepithelial neoplasia (VIN) or to human papillomavirus (HPV)-related usual (u) VIN. Multicentric HPV infections (cervix, vagina and vulva) are common. We hypothesise that patients with a uVIN-related vulvar SCC more often have cervical high-grade squamous intraepithelial lesions (HSILs) compared with women with dVIN-related vulvar SCC. Methods: All vulvar SCCs (201) were classified to be dVIN- (n=164) or uVIN related (n=37). Data with regard to the smear history and cervical histology were retrieved from PALGA, the nationwide Netherlands database of histo- and cytopathology. For HSIL cervical smears of which histology was taken, HPV DNA analysis on both the vulvar and cervical specimens was performed. Results: At least one smear was available in 145 (72%) of the 201 patients. Patients with a uVIN-related vulvar SCC more often had an HSIL compared with patients with a dVIN-related SCC (35 vs 2%, P<0.001). A total of 10 of the 13 HSILs were histologically assessed and identical HPV types were found in the vulva and cervix. Conclusion: These data emphasise the necessity to differentiate between dVIN- and uVIN-related vulvar tumours and to examine the entire lower female ano-genital tract once an uVIN-related lesion is found. PMID:19513077

de Bie, R P; van de Nieuwenhof, H P; Bekkers, R L M; Melchers, W J G; Siebers, A G; Bulten, J; Massuger, L F A G; de Hullu, J A

2009-01-01

419

Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes  

PubMed Central

Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction. PMID:25075361

Kang, Gavin Chun-Wui; Tay, Eng Hseon; Por, Yong Chen

2014-01-01

420

Description of Meloidoderita polygoni n. sp. (Nematoda: Meloidoderitidae) from USA and Observations on M. kirjanovae from Israel and USSR  

PubMed Central

Meloidoderita polygoni n. sp. is described and illustrated from roots of smartweed (Polygonum hydropiperoides) from Beltsville, Maryland. This new species is similar to M. kirjanovae but differs especially in having larger spines on the cystoid bodies, females with the anus much closer to the vulva, and more posterior excretory pore. M. polygoni differs from M. safrica particularly in having females with a shorter stylet, a DGO much closer to base of stylet, greater distance between vulva and anus, and larger cystoid bodies. LM and SEM observations showed only three incisures in lateral fields of juveniles and males and no bursa in males. Morphometric data and illustrations are given for M. kirjanovae from mint (Mentha longifolia) in Israel and some details on a limited number of specimens from Armenian SSR. LM examination of juveniles from both these areas indicated only three incisures in lateral fields. Males from Israel had no detectable bursa and appeared to have only three incisures in lateral fields. (Males from Armenian SSR not observed.) PMID:19294022

Golden, A. Morgan; Handoo, Zafar A.

1984-01-01

421

Calcaridorylaimus castaneae sp. n. (Nematoda, Dorylaimidae) from Bulgaria with an identification key to the species of the genus  

PubMed Central

Abstract An unknown species belonging to the genusCalcaridorylaimus Andrássy, 1986 was collected from the litter of broadleaf forests dominated by Castanea sativa Mill. and mixed with Quercus daleshampii Ten. and Fagus sylvatica L. on Belasitsa Mountain, south-western Bulgaria. Calcaridorylaimus castaneae sp. n. is characterised by its long body (1.4–2.1 mm), lip region practically not offset, vulva transverse, short odontostyle (14.5–16 ?m) and tail (75.5–110.5 ?m, c=14.7–23.6; c’=2.9–4.4) in females and 38–46 ?m long spicules with small spur before their distant end in males. It is most similar to C. andrassyi Ahmad & Shaheen, 2004, but differs in having transverse vs pore-like vulva and shorter spicules (38–46 ?m vs 52–57 ?m). An identification key to the species of the genus Calcaridorylaimus is proposed. Phylogenetic analyses were performed on 18S and D2-D3 expansion domains of 28S rRNA genes by Neighbor-Joining, Maximum Likelihood and Bayesian Inference methods. The phylograms inferred from 18S sequences showed closest relationships of the new species with some species belonging to the genus Mesodorylaimus. However, insufficient molecular data for members of both genera do not allow the phylogenetic relationships of Calcaridorylaimus and the new species described herein to be elucidated. PMID:24899849

Nedelchev, Sevdan; Elshishka, Milka; Lazarova, Stela; Radoslavov, Georgi; Hristov, Peter; Peneva, Vlada

2014-01-01

422

Solar ultraviolet-B exposure and cancer incidence and mortality in the United States, 1993–2002  

PubMed Central

Background An inverse relationship between solar ultraviolet-B (UV-B) exposure and non-skin cancer mortality has long been reported. Vitamin D, acquired primarily through exposure to the sun via the skin, is believed to inhibit tumor development and growth and reduce mortality for certain cancers. Methods We extend the analysis of this relationship to include cancer incidence as well as mortality, using higher quality and higher resolution data sets than have typically been available. Over three million incident cancer cases between 1998 and 2002 and three million cancer deaths between 1993 and 2002 in the continental United States were regressed against daily satellite-measured solar UV-B levels, adjusting for numerous confounders. Relative risks of reduced solar UV-B exposure were calculated for thirty-two different cancer sites. Results For non-Hispanic whites, an inverse relationship between solar UV-B exposure and cancer incidence and mortality was observed for ten sites: bladder, colon, Hodgkin lymphoma, myeloma, other biliary, prostate, rectum, stomach, uterus, and vulva. Weaker evidence of an inverse relationship was observed for six sites: breast, kidney, leukemia, non-Hodgkin lymphoma, pancreas, and small intestine. For three sites, inverse relationships were seen that varied markedly by sex: esophagus (stronger in males than females), gallbladder (stronger in females than males), and thyroid (only seen in females). No association was found for bone and joint, brain, larynx, liver, nasal cavity, ovary, soft tissue, male thyroid, and miscellaneous cancers. A positive association between solar UV-B exposure and cancer mortality and incidence was found for anus, cervix, oral cavity, melanoma, and other non-epithelial skin cancer. Conclusion This paper adds to the mounting evidence for the influential role of solar UV-B exposure on cancer, particularly for some of the less-well studied digestive cancers. The relative risks for cancer incidence are similar to those for cancer mortality for most sites. For several sites (breast, colon, rectum, esophagus, other biliary, vulva), the relative risks of mortality are higher, possibly suggesting that the maintenance of adequate vitamin D levels is more critical for limiting tumor progression than for preventing tumor onset. Our findings are generally consistent with the published literature, and include three cancer sites not previously linked with solar UV-B exposure, to our knowledge: leukemia, small intestine, and vulva. PMID:17096841

Boscoe, Francis P; Schymura, Maria J

2006-01-01

423

Imaging and clinical properties of inflammatory demyelinating pseudotumor in the spinal cord  

PubMed Central

Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas. It is often misdiagnosed as intramedullary tumor and surgically resected. In view of this, the clinical and magnetic resonance imaging manifestations and the pathological fea-tures of 36 cases of inflammatory demyelinating pseudotumor in the spinal cord were retrospec-tively analyzed and summarized. Most of these cases suffered from acute or subacute onset and exhibited a sensorimotor disorder. Among them, six cases were misdiagnosed as having intra-dullary gliomas, and inflammatory demyelinating pseudotumor was only identified and pathologi-cally confirmed after surgical resection. Lesions in the cervical and thoracic spinal cord were com-mon. Magnetic resonance imaging revealed edema and space-occupying lesions to varying grees at the cervical-thoracic junction, with a predominant feature of non-closed rosette-like forcement (open-loop sign). Pathological examination showed perivascular cuffing of predominantly dense lymphocytes, and demyelination was observed in six of the misdiagnosed cases. These re-sults suggest that tumor-like inflammatory demyelinating disease in the spinal cord is a kind of special demyelinating disease that can be categorized as inflammatory pseudotumor. These solitary lesions are easily confused with intramedullary neoplasms. Patchy or non-closed reinforcement (open-ring sign) on magnetic resonance imaging is the predominant property of inflammatory myelinating pseudotumor, and inflammatory cell infiltration and demyelination are additional pa-logical properties. PMID:25206559

Wang, Ying; Wang, Min; Liang, Hui; Yu, Quntao; Yan, Zhihui; Kong, Min

2013-01-01

424

Primary spinal epidural cavernous hemangioma: clinical features and surgical outcome in 14 cases.  

PubMed

OBJECT The aim of this study was to investigate the clinical characteristics, imaging features, differential diagnosis, treatment options, and prognosis for primary spinal epidural cavernous hemangiomas. METHODS Fourteen patients with pathologically diagnosed non-vertebral origin cavernous hemangiomas who had undergone surgery at Beijing Tiantan Hospital between 2003 and 2012 were identified in the hospital's database. The patients' clinical data, imaging characteristics, surgical treatment, and postoperative follow-up were analyzed retrospectively. RESULTS There were 9 males and 5 females with an average age of 51.64 years. The primary epidural cavernous hemangiomas were located in the cervical spine (2 cases), cervicothoracic junction (2 cases), thoracic spine (8 cases), thoracolumbar junction (1 case), and lumbar spine (1 case). Hemorrhage was confirmed in 4 cases during surgery. Preoperatively 5 lesions were misdiagnosed as schwannoma, 1 was misdiagnosed as a meningioma, and 1 was misdiagnosed as an arachnoid cyst. Preoperative hemorrhages were identified in 2 cases. Three patients had recurrent cavernous hemangiomas. The initial presenting symptoms were local pain in 5 cases, radiculopathy in 6 cases, and myelopathy in 3 cases. Upon admission, 1 patient had radicular symptoms and 13 had myelopathic symptoms. The average symptom duration was 18 months. All patients underwent surgery; complete resection was achieved in 8 cases, subtotal resection in 4 cases, and partial resection in 2 cases. Postoperative follow-up was completed in 10 cases (average follow-up 34 months); 1 patient died, 5 patients showed clinical improvement, and 4 patients remained neurologically unchanged. CONCLUSIONS Total surgical removal of spine epidural cavernous hemangiomas with a chronic course is the optimum treatment and carries a good prognosis. Secondary surgery for recurrent epidural cavernous hemangioma is technically more challenging. In patients with profound myelopathy from acute hemorrhage, even prompt surgical decompression can rarely reverse all symptoms. PMID:25343406

Li, Teng-Yu; Xu, Yu-Lun; Yang, Jun; Wang, James; Wang, Gui-Huai

2015-01-01

425

Tinea atypica: report of nine cases.  

PubMed

Fungal infections of the skin are a common condition, usually easy to diagnose and treat. When the infection is clinically mimicking another cutaneous disorder or when the clinical presentation is modified by the use of inappropriate treatment, it is referred to as tinea atypica or tinea incognito.We report a series of nine cases of patients with tinea atypica, imitating and diagnosed initially as different skin diseases. Two patients were defined as pyoderma in the facial and pubic regions (caused respectively by Trichophyton mentagrophytes var. mentagrophytes and Microsporum canis) and one as herpes zoster ophthalmicus (caused by Trichophyton rubrum). Six additional patients were initially misdiagnosed: (1) Plaque-like formation of the skin misdiagnosed as an impetiginized eczema (with isolated agent Trichophyton verrucosum). (2) A rare form of skin infection of the hand caused by T. rubrum, imitating clinically cutaneous infection with tuberculum mulgentium. (3) Rosacea-like dermatitis with an isolated agent Fusarium. (4) A patient with the typical clinical symptoms of seborrheic dermatitis of the face (and with isolated T. rubrum as a causative agent). (5) Another patient presented with a widespread folliculitis by Trichophyton mentagrophytes. (6) In a patient with bullous pemphigoid and immunosuppression pemphigoid-like eruptions were caused by Malassezia pachydermatis and T. rubrum. The diagnosis in the presented cases was based on direct microscopic examination with KOH and a culture on Sabouraud agar.After the diagnosis of tinea, treatment with topical and systemic antifungal agents was administrated, followed by complete clinical remissions in all cases.The clinical manifestations of tinea atypica can mimic a large number of other dermatoses, which often leads to misdiagnosing, and as a consequence--to serious difficulties in the management of clinical symptoms and in offering appropriate therapy. PMID:23949566

Zisova, Liliya Georgieva; Dobrev, Hristo Petrov; Tchernev, Georgi; Semkova, Kristina; Aliman, Anastasia Atanasova; Chorleva, Kristina Ivanova; Chapanova, Antonina Teneva; Vutova, Nina Ivanova; Wollina, Uwe

2013-12-01

426

Elongated left lobe of the liver mimicking a subcapsular hematoma of the spleen on the focused assessment with sonography for trauma exam.  

PubMed

The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking contained fluid collections with hemoperitoneum. We present a case in which an elongated left lobe of the liver was misdiagnosed as a splenic subcapsular hematoma. It is imperative that emergency physicians and trauma surgeons be familiar with this normal variant of the liver and its associated sonographic appearance on the perisplenic window in order to prevent nontherapeutic laparotomies or embolizations. PMID:24556519

Jones, Robert; Tabbut, Matthew; Gramer, Diane

2014-07-01

427

Pulmonary arteriovenous malformations presenting as refractory heart failure  

PubMed Central

A 22-year-old young man with a history of idiopathic dilated cardiomyopathy (IDC) was admitted to our hospital due to difficult-to-control heart failure. A thoracic X-ray showed multiple nodules at the both pulmonary hilus and upper lobe of the right lung. Computed tomography (CT) angiography of the thorax confirmed arteriovenous malformation (AVM). However, effective treatment was impossible due to the poor physical condition; he died a few days later. Here we reported on the case of pulmonary arteriovenous malformations (PAVMs) being misdiagnosed as refractory heart failure. PMID:25276390

Chen, Kai-Hong; Huang, Guo-Yong; Song, Wei

2014-01-01

428

Rheumatoid-like deformities in Parkinson’s disease with 1-year follow-up: case report and literature review  

Microsoft Academic Search

Rheumatoid-like deformities in joints are uncommon in patients with Parkinson’s disease and easy to be misdiagnosed with rheumatoid\\u000a arthritis. Therefore, unnecessary treatment is often initiated. Here, we report a case of a 60-year-old woman with Parkinson’s\\u000a disease developing a rheumatoid-like joint deformities, and evaluate 1-year follow-up outcome. We also review the literature\\u000a and discuss the clinical characteristics, possible pathogenesis, and

Xiaoming Shu; Guochun Wang; Xin Lu; Yao Xie

2010-01-01

429

Transient epileptic amnesia: clinical report of a cohort of patients.  

PubMed

Transient epileptic amnesia is a seizure disorder, usually with onset in the middle-elderly and good response to low dosages of antiepileptic drugs. We describe the clinical, electroencephalography (EEG), and neuroimaging features of 11 patients with a temporal lobe epilepsy characterized by amnesic seizures as the sole or the main symptom. We outline the relevance of a detailed clinical history to recognize amnesic seizures and to avoid the more frequent misdiagnoses. Moreover, the response to monotherapy was usually good, although the epileptic disorder was symptomatic of acquired lesions in the majority of patients. PMID:24214286

Lapenta, Leonardo; Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Giannantoni, Nadia Mariagrazia; Quaranta, Davide; Di Lazzaro, Vincenzo; Della Marca, Giacomo

2014-07-01

430

Foreign Body Aspiration Presenting with Asthma-Like Symptoms  

PubMed Central

Aspiration of a foreign body into the tracheobronchial tree is rare in adults. In the majority of these cases there is an underlying condition such as mental retardation, depressed mental status, impairment in the swallowing reflex, neurological impairment, alcohol or sedative abuse, or complications from dental manipulations that contributed to the aspiration. These patients are commonly misdiagnosed with asthma and typically do not respond to mainstay anti-inflammatory and/or bronchodilator therapy. We describe the case of a patient with a foreign body aspiration in the upper trachea not recognized by radiographic studies that presented with asthma-type symptoms. PMID:24454397

Kam, Jennifer C.; Doraiswamy, Vikram; Dieguez, Javier F.; Govind, Mayur; Miller, Richard; Adelman, Marc

2013-01-01

431

Recurrent amyloidoma of soft tissue with exuberant giant cell reaction.  

PubMed

Amyloidoma (localized tumorlike amyloidosis) in the soft tissues is rare. We present an instructive case of recurrent amyloidoma in the soft tissue of the ankle in a 45-year-old man with multiple surgical procedures and chronic osteomyelitis of the underlying bones. The lesion evaded diagnosis because of a florid giant cell reaction that led to various misdiagnoses, including giant cell tumor of tendon sheath, foreign body reaction secondary to surgery, and pseudogout. This case demonstrates the importance of considering the possibility of amyloidoma when a giant cell-rich lesion is encountered in the soft tissues. PMID:14632568

Mukhopadhyay, Sanjay; Damron, Timothy A; Valente, Alfredo L

2003-12-01

432

Magnetic Resonance Imaging of the Pediatric Knee.  

PubMed

In pediatric patients, the high resolution and excellent soft-tissue contrast of magnetic resonance (MR) imaging allows for complete evaluation of osseous and soft-tissue structures around the knee joint, and its lack of ionizing radiation makes it a preferred modality for advanced imaging. Older children and adolescents are most commonly imaged to evaluate athletic and traumatic injuries, whereas in infants and school age children MR imaging is used to evaluate developmental conditions such as Blount disease or assess for causes of atraumatic pain such as infection or inflammatory arthritis. A thorough understanding of normal skeletal development is necessary to avoid misdiagnoses. PMID:25442031

Gill, Kara G; Nemeth, Blaise A; Davis, Kirkland W

2014-11-01

433

Misdiagnosis of Bipolar Disorder  

PubMed Central

The objective of this article is to review the literature on one of the most complex topics in contemporary psychiatry—the diagnosis of bipolar disorder. Bipolar disorder is a disabling psychiatric illness that is often misdiagnosed, especially on initial presentation. Misdiagnosis results in ineffective treatment, which further worsens the outcome. Major contributors toward misdiagnosis include lapses in history-taking, presence of psychiatric and medical comorbidities, and limitations in diagnostic criteria. Careful screening for symptoms of hypomania/mania and clinical features suggestive of bipolarity as well as use of collateral history and screening instruments, such as mood questionnaires, might help in limiting the rate of misdiagnosis. PMID:20877548

Rajput, Muhammad

2006-01-01

434

Multimodal imaging for the diagnosis of an atypical case of central serous chorioretinopathy.  

PubMed

We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management. PMID:25371645

Kahloun, Rim; Chebbi, Amel; Amor, Sofiene Ben; Ksiaa, Imen; Nacef, Leila; Khairallah, Moncef

2014-01-01

435

Multimodal Imaging for the Diagnosis of an Atypical Case of Central Serous Chorioretinopathy  

PubMed Central

We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management. PMID:25371645

Kahloun, Rim; Chebbi, Amel; Amor, Sofiene Ben; Ksiaa, Imen; Nacef, Leila; Khairallah, Moncef

2014-01-01

436

Angiosarcoma of the penis: a case report and literature review.  

PubMed

We reported one case of penile angiosarcoma in a 49-year-old patient who had been misdiagnosed as syphilis. Based on our experience, we suggest that if sexually transmitted diseases and Peyronie's disease can be ruled out, diagnosis of the penile angiosarcoma be warranted if unexplained rash, ulceration on the penis, and induration in corpus cavernosum are observed. It should be noted that if the anti-inflammatory or anti-viral treatment is prescribed for some time but the lesion does not disappear or even gets worse, the penile angiosarcoma should be suspected and penile biopsy is necessary. PMID:22767178

Wu, Xiaojun; Chen, Zhiwen; Ji, Huixiang; Duan, Guangjie; Zhou, Zhansong

2012-10-01

437

A Surgeon's Perspective of Abdominal Wall Endometriosis at a Caesarean Section Incision: Nine Cases in a Single Institution  

PubMed Central

Abdominal wall endometriosis in a Caesarean section scar (AEC) is an infrequent type of extrapelvic endometriosis which rarely transforms into a malignant lesion. A painful mass located in the scar of a Caesarean section is a typical sign of AEC. This condition is diagnosed preoperatively using imaging modalities such as computed tomography and ultrasonography, as well as fine-needle aspiration. Although AEC has typical signs, general surgeons often misdiagnose it due to its rarity. Herein, we report our experience of AEC in a single institution. PMID:25379559

Lee, Won-Suk; Kang, Jin Mo; Choi, Sang Tae; Kim, Keon Kuk; Lee, Woon Kee

2014-01-01

438

[Huge primary teratoma in the preperitoneal space: a case report and literature review].  

PubMed

Huge primary teratoma in the preperitoneal space is an extremely rare clinical entity and can be easily misdiagnosed as tumors of the intraperitoneal or pelvic origin. We report a case of primary huge mature teratoma in the preperitoneal space in a 74-year-old women, and reviews the clinical data and the diagnosis and treatment of this case. The patient underwent complete resection of the teratoma, which was the optimal treatment option. The patient was followed-up for 10 months and no signs of recurrence were found, suggesting a favorable prognosis. PMID:25613635

Lei, Rui-Lin; Xiao, Song-Shu; Xue, Min

2015-01-20

439

Paradoxical vocal cord motion disorder: past, present and future  

PubMed Central

Paradoxical vocal cord motion disorder (PVCM), also called vocal cord dysfunction, is an important differential diagnosis for asthma. The disorder is often misdiagnosed as asthma leading to unnecessary drug use, very high medical utilisation and occasionally tracheal intubation or tracheostomy. Laryngoscopy is the gold standard for diagnosis of PVCM. Speech therapy and psychotherapy are considered the cornerstone of management of this disorder. The aim of this article is to increase the awareness of PVCM among doctors, highlighting the main characteristics that distinguish it from asthma and discuss the recent medical achievements and the possible future perspectives related to this disorder. PMID:17344570

Ibrahim, Wanis H; Gheriani, Heitham A; Almohamed, Ahmed A; Raza, Tasleem

2007-01-01

440

Branchial cleft cyst: A case report and review of literature  

PubMed Central

First branchial cleft anomaly is a rare disease of the head and neck. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. In this article, we present a case of type II first branchial cleft anomaly. A middle-aged woman who had suffered from swelling on lower jaw visited our department with the chief complaint of a swelling. She underwent complete excision of the lesion with preservation of the facial nerve. The patient recovered well and had no recurrence at 1-year of follow up. PMID:24959062

Chavan, Surekha; Deshmukh, Revati; Karande, Prasad; Ingale, Yeshwant

2014-01-01

441

Remote cutaneous breast carcinoma metastasis mimicking dermatitis.  

PubMed

Cutaneous metastases from primary internal malignancies are an uncommon presentation. Cutaneous metastases are more frequently seen in breast cancer than in any other visceral malignancy in women. Medical practitioners should be vigilant of the possibility of unusual presentations of metastatic disease in breast cancer patients with lobular carcinoma presenting as cutaneous lesions mimicking benign dermatological conditions. Herein, we present a case of a 75-year-old woman presenting with cutaneous lobular breast carcinoma metastases on her anterior right leg, which had previously been misdiagnosed as dermatitis for 9 years. PMID:25657439

Navaratnam, Annakan V; Chandrasekharan, Sankaran

2015-01-01

442

Remote Cutaneous Breast Carcinoma Metastasis Mimicking Dermatitis  

PubMed Central

Cutaneous metastases from primary internal malignancies are an uncommon presentation. Cutaneous metastases are more frequently seen in breast cancer than in any other visceral malignancy in women. Medical practitioners should be vigilant of the possibility of unusual presentations of metastatic disease in breast cancer patients with lobular carcinoma presenting as cutaneous lesions mimicking benign dermatological conditions. Herein, we present a case of a 75-year-old woman presenting with cutaneous lobular breast carcinoma metastases on her anterior right leg, which had previously been misdiagnosed as dermatitis for 9 years. PMID:25657439

Navaratnam, Annakan V; Chandrasekharan, Sankaran

2015-01-01

443

Medial canthus retiform hemangioendothelioma  

PubMed Central

Retiform hemangioendothelioma (RH) is a distinct entity in the spectrum of vascular tumors with a high local recurrence rate. It is considered a low-grade, well-differentiated cutaneous angiosarcoma with low metastatic potential. We report here for the first time a case of medial canthus recurrent RH. It may be helpful in our practice to include RH as a differential diagnosis of eyelid lesions. It is noteworthy that the progressive course and recurrence tendency of RH might be misdiagnosed as angiosarcoma or basal cell carcinoma (BCC), if not expected and carefully evaluated by the pathologist. PMID:24817752

Al-Faky, Yasser H; Al-Mosallam, Abdul Rahman; Al-Rikabi, Ammar C; Al-Sohaibani, Mohammed O

2014-01-01

444

Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women  

Microsoft Academic Search

Purpose  Vaginal infection with group A streptococci (GAS) is an established cause of vaginitis amongst prepubescent girls, but largely\\u000a unrecognized in adult women and therefore often misdiagnosed as vulvovaginal candidosis. We sought to give an overview of\\u000a the epidemiology, risk factors, symptoms, signs, and treatment of GAS vaginitis in adult women.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Systematic literature search.\\u000a \\u000a \\u000a \\u000a Results  We identified nine case reports covering 12

Hans Verstraelen; Rita Verhelst; Mario Vaneechoutte; Marleen Temmerman

2011-01-01

445

Benign giant schwannoma located in the upper arm.  

PubMed

A 72-year-old-female presented with a giant schwannoma on the medial side of her right upper arm. Ultrasonographic and magnetic resonance imaging examinations showed that it was almost a totally cystic lesion. It was initially misdiagnosed as a hydatid cyst. After excision of the tumor, histopathological examination revealed that it was a schwannoma composed of two types of regions known as Antoni A and B regions. The tumor was 15 x 8 x 7 cm in size. There were no neurological sequelae after the operation. This is probably the biggest schwannoma of the upper extremity reported. PMID:9229103

Kececi, Y; Gurler, T; Gundogan, H; Bilkay, U; Cagdas, A

1997-07-01

446

Crowned dens syndrome diagnosed on ¹?F-FDG PET/CT.  

PubMed

An 87-year-old woman with corticosteroid-resistant polymyalgia rheumatica underwent ¹?F-FDG PET/CT for suspected giant cell arteritis or neoplastic disease. FDG uptake in the immediate vicinity of the odontoid process, with a crownlike calcification, was identified on the CT scan on the posterior side of the dens, thus confirming the diagnosis of crowned dens syndrome. Because this rare syndrome is frequently misdiagnosed, nuclear physicians should be aware of the signs and symptoms of this condition, which may call for the use of PET/CT imagery. PMID:25243939

Monet, Antoine; Massonnat, Richard; Merino, Bertrand; Riviere, Annalisa; Richez, Christophe

2014-12-01

447

Hypertrophic nonunion humerus mimicking an enchondroma.  

PubMed

Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face. PMID:25525539

Magu, N K; Singh, Amanpreet; Mukhopadhyay, Reetadyuti; Wadhwani, Jitendra; Gogna, Paritosh; Singla, Rohit; Arora, Sahil; Mukhopadhyay Chatterjee, Pragnashree

2014-01-01

448

Aggressive angiomyxoma: a small palpable vulvar lesion with a huge mass in the pelvis.  

PubMed

Aggressive angiomyxoma (AAM) is a rare soft tissue tumor typically in the pelvis and perineum in women of reproductive age, which is easily misdiagnosed. We describe a woman with vulvar AAM, initially mismanaged as a Bartholin cyst. However, a huge pelvic mass is noted on the following imaging studies. The characteristics of AAM on computed tomography and magnetic resonance imaging have been specified in the literature, but we further point out the potential value of sonography in diagnosing AAM. Besides, excisional biopsy may cause tumor bleeding in a case of AAM. PMID:23222052

Huang, Chun-Chao; Sheu, Chin-Yin; Chen, Tung-Ying; Yang, Yuh-Cheng

2013-01-01

449

Large perineal and gluteal angiomyxoma: the role of diagnostic imaging and literature review.  

PubMed

Aggressive angiomyxoma is a benign soft tissue tumour usually affecting the pelvis and perineum predominantly in women. Because of its variable presentation, this tumour is often clinically misdiagnosed as liposarcoma. We describe a case of a 38-year-old woman who presented with a large perineal and gluteal mass which increased in size in one year. Ultrasound showed hypoechoic mixed solid and cystic mass. Contrasted CT and MRI examinations showed typical appearance of swirling and layering pattern. She had undergone TAHBSO as the mass was difficult to dissect intra-operatively. The post-operative specimen confirmed to be an aggressive angiomyxoma. PMID:23429032

Alhabshi, Sharifah Majedah Idrus; Abd Rashid, M

2013-01-01

450

Toxoplasmosis with hemophagocytic syndrome after bone marrow transplantation: diagnosis at autopsy.  

PubMed

Toxoplasmosis is a rare but well recognized opportunistic infection that can occur after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Besides encephalitis, other common presentations of Toxoplasma gondii infection are interstitial pneumonitis and myocarditis. Because of its non-specific clinical and biological signs and its lethal outcome, toxoplasmosis is often misdiagnosed and only revealed at autopsy. We report a case of a postmortem diagnosis of disseminated toxoplasmosis associated with hemophagocytic syndrome, which underlines the value of necropsy in cases of death after transplantation. We also discuss clinical presentations and risk factors that lead to toxoplasmosis in allo-HSCT recipients. PMID:18384483

Duband, S; Cornillon, J; Tavernier, E; Dumollard, J-M; Guyotat, D; Péoc'h, M

2008-10-01

451

Nonepileptic motor phenomena in the neonate  

PubMed Central

The newborn infant is prone to clinical motor phenomena that are not epileptic in nature. These include tremors, jitteriness, various forms of myoclonus and brainstem release phenomena. They are frequently misdiagnosed as seizures, resulting in unnecessary investigations and treatment with anticonvulsants, which have potentially harmful side effects. Unfortunately, there is a paucity of literature about many of these phenomena in the newborn, and some of the major textbooks refer to these events as nonepileptic seizures, leading to further confusion for the practitioner. The present paper aims to review these phenomena with special emphasis on differentiating them from epileptic seizures, and offers information on treatment and prognosis wherever possible. PMID:19436521

Huntsman, Richard James; Lowry, Noel John; Sankaran, Koravangattu

2008-01-01

452

Aneurysmal Bone Cysts of the Spine: Two Case Reports  

PubMed Central

Aneurysmal bone cysts are rare entities which causes expansile and destructive bone lesions characterized by reactive proliferation of connective tissue. They usually grow rapidly with hypervascularity. In clinical practice they can be easily misdiagnosed due to the rare occurance and having no such typical findings as radiologically. Most cases have uncommon pain symptoms, but rarely, if fractures occur, neurological findings can be seen and the surgical treatment, if needed, could be difficult. We will discuss our evaluations to two cases that we experienced in our clinic in this report.

Ozdemir, Seymen; Ozden, Ferhat; Kacira, Ozlem Kitiki; Kacira, Tibet

2014-01-01

453

Intraabdominal focal fat infarction in a 75-year-old woman presenting as acute abdomen.  

PubMed

Epiploic appendagitis is a rare, self-limiting inflammation of the epiploic appendices or omental appendices. It presents as abdominal pain often misdiagnosed as appendicitis, cholecystitis, or diverticulitis. Epiploic appendagitis can be treated conservatively with anti-inflammatory and pain medications. It is important to diagnose this etiology of abdominal pain in order to avoid long-term hospital stay and other medical expenses including surgery. In this case report we present a rare case of epiploic appendagitis that presents in a 75 year old female patient. PMID:22424988

Arora, Shitij; Goyal, Hemant; Aggarwal, Prachi; Duffoo, Frantz; Basavaiah, Thara; Patel, Jigar; Hossain, Afzal

2012-11-01

454

Anxiety disorders in primary care.  

PubMed

Anxiety disorders are the most common psychiatric condition presenting to primary care practitioners. Yet they can be easily overlooked or misdiagnosed. Patients that struggle with anxiety disorders are more likely to seek treatment from primary care providers than mental health specialists. Given the costs in terms of debilitation and associated financial burden, and increased risk of suicide, the identification and successful treatment of anxiety is imperative. By means of clinical acumen and the use of screening tools, the provider can develop expertise in recognition and effective treatment of anxiety disorders. PMID:25134870

Combs, Heidi; Markman, Jesse

2014-09-01

455

Tracheal adenoid cystic carcinoma masquerading asthma: A case report  

PubMed Central

Background Tracheal tumors are often misdiagnosed as asthma and are treated with inhaled steroids and bronchodilators without resolution. Case Presentation Here, a patient with tracheal adenoid cystic carcinoma who had been previously diagnosed with difficult asthma was reported. The possibility of the presence of localized airway obstruction was raised when the flow-volume curve suggesting fixed airway obstruction, was obtained. Conclusion The presenting case report emphasizes the fact that not all wheezes are asthma. It is critical to bear in mind that if a patient does not respond to appropriate anti-asthma therapy, localized obstructions should be ruled out before establishing the diagnosis of asthma. PMID:15494074

Kokturk, Nurdan; Demircan, Sedat; Kurul, Cuneyt; Turktas, Haluk

2004-01-01

456

Raised Serum Ferritin Concentration in Hereditary Hyperferritinemia Cataract Syndrome Is Not a Marker for Iron Overload  

PubMed Central

Hyperferritinemia and bilateral cataracts are features of the rare hereditary hyperferritinemia cataract syndrome (HHCS; OMIM #600886). HHCS is an autosomal dominant condition caused by mutations which increase expression of the ferritin light polypeptide (FTL) gene. We report a patient with HHCS who was misdiagnosed and treated as having hemochromatosis, in whom a heterozygous c.-160A>G mutation was identified in the iron responsive element (IRE) of FTL, causing ferritin synthesis in the absence of iron overload. This report demonstrates the need for clinical awareness of HHCS as a cause of hyperferritinemia in the absence of iron overload and provides a possible diagnostic schema. (Hepatology 2014;59:1204–1206) PMID:24003015

Yin, Dan; Kulhalli, Vasu; Walker, Ann P

2014-01-01

457

2011: the scurvy Odyssey.  

PubMed

The authors report the case of a 50-year-old alcoholic man with chronic hepatitis C virus infection, who presented to the emergency department with fever and exuberant ecchymoses and petechiae on both legs. After a careful examination and laboratory assessment, the not-so-obvious hypothesis of scurvy was disclosed. Simply with vitamin C replacement and nutritional advice, a dramatic improvement in his condition was observed. In modern societies, a generalised access to food renders scurvy as a rare disease, often misdiagnosed. A multidisciplinary approach is emphasised as the key to a more simple differential diagnosis, avoiding unnecessary exams and preventing serious complications, or even death, if left untreated. PMID:22987898

Bernardino, V R; Mendes-Bastos, Pedro; Noronha, Carla; Henriques, Celia Coelho

2012-01-01

458

Multiple myeloma mimicking spondyloarthritis: a case report.  

PubMed

MULTIPLE myeloma (MM) is a hematologic malignancy of differentiated plasma cells that accumulate and proliferate in the bone marrow. MM patients often develop bone disease that results in severe bone pain, osteolytic lesions, and pathologic fractures,1 presenting with unexplained backache or bone pain in the long bones, ribs, skull, or pelvis.2 However, the low backache mimicking spondyloarthritis in MM is uncommon during clinical practice. Spondyloarthritis is a chronic systemic inflammatory disorder of the axial skeleton, mainly affecting the sacroiliac joint and spine causing low backache.3 Here we report a patient with MM which was initially misdiagnosed and treated as spondyloarthritis. PMID:25429752

Liu, Ai-Chun; Liu, Yan-Ying; Li, Yan; Zhang, Li; Li, Zhan-Guo

2014-11-28

459

Acute spontaneous chylous peritonitis: report of a case.  

PubMed

Acute abdominal pain with peritonitis due to sudden extravasation of lymph into the peritoneal cavity is a rare condition that is often mistaken for other causes of acute abdomen. The diagnosis of spontaneous chylous peritonitis is rarely suspected preoperatively, usually misdiagnosed with diverse common surgical emergencies. We report the case of an 81 year old female who presented with typical symptoms of acute abdomen, presumed as acute mesenteric ischemia. The diagnosis of chylous peritonitis was established during laparoscopy and treatment consisted of low fat diet and octreotide. PMID:20922202

Mishin, Igor; Ghidirim, Gheorghe; Vozian, Marin

2010-09-01

460

Cutaneous dental sinus tract, a common misdiagnosis: a case report and review of the literature.  

PubMed

Cutaneous sinus tracts of dental origin are often initially misdiagnosed and inappropriately treated because of their uncommon occurrence and the absence of symptoms in approximately half the individuals affected. Patients are often referred with a recurrent or chronic cyst, a furuncle, or an ulcer on the face or neck. Correct diagnosis is based on a high index of suspicion and on radiologic evidence of a periapical root infection. Appropriate treatment results in predictable and rapid healing of these lesions. We present a case report of this common misdiagnosis and a review of the literature with regard to diagnosis and treatment. PMID:12469779

Cantatore, Julie L; Klein, Peter A; Lieblich, Lawrence M

2002-11-01

461

What is Susac syndrome? - A brief review of articles  

PubMed Central

Susac’s syndrome (SS) is a clinical triad of encephalopathy, branch retinal artery occlusion and sensorineural hearing loss and maybe due to an immune-mediated endotheliopathy. Because of its rarity and some similarities to other common neurological conditions such as multiple sclerosis and acute disseminated encephalomyelitis, it is often misdiagnosed and therefore mistreated. To the best of our knowledge, there is only one case report from our country with this diagnosis. Here, we have a short discussion on this issue to introduce it to our colleagues and remind it as a differential diagnosis in patients with unexplained encephalopathy.

Nazari, Ferdos; Azimi, Amirreza; Abdi, Siamak

2014-01-01

462

True vertical tooth root fracture: Case report and review  

PubMed Central

It is important for the clinician not only to gather as much information about a case as possible, but also to be able to correctly interpret the data to arrive at an accurate diagnosis. Occasionally, a case presents with symptoms that might be suggestive of a condition; however, the final diagnosis may be totally different. This paper reports on an interesting case of a true vertical root fracture, in an intact maxillary molar in a 55-year-old man. The case was misdiagnosed and treated as a periodontal defect for over two months. The paper discusses the various causes and diagnostic dilemmas of root fractures. PMID:22090779

Bhaskar, U.; Logani, A.; Shah, Naseem

2011-01-01

463

Langerhans cell histiocytosis presenting as hypothyroid goitre: a unique presentation.  

PubMed

Langerhans cell histiocytosis (LCH) is a disease involving the antigen presenting cells, which can range from a single system involvement with an indolent course to a multisystem disease with increased morbidity. We present a rare case of LCH presenting as hypothyroid goitre that was successfully treated as per the LCH III trial protocol with a combination of vinblastine and oral prednisolone. We highlight the need for awareness of this rare presentation of LCH as a painless goitre which is often misdiagnosed as poorly differentiated thyroid carcinoma or overlooked as a benign disease. PMID:25465459

Marupudi, Krishna Chaitanya; Karanth, Suman S; Thomas, Joseph

2014-01-01

464

Diagnosis and treatment of extra-adrenal pheochromocytoma of urinary bladder: case report and literature review  

PubMed Central

Pheochromocytoma of the urinary bladder is often misdiagnosed as it is a rare tumor. In this report, we described a case with primary pheochromocytoma of the urinary bladder. We specifically conversed the diagnostic role of X-ray computed tomography and sonography to identify the location of tumor within urinary bladder compared to other malignant or benign tumors in the bladder, and exclude other ectopic pheochromocytoma. Histopathological report from bladder tissue biopsy was confirmative of extra adrenal pheochromocytoma of the urinary bladder finally. Importance in careful management of hypertensive crisis during cystoscope and partial cystectomy was addressed. PMID:24179580

Li, Wei; Yang, Bin; Che, Jian-Ping; Yan, Yang; Liu, Min; Li, Qian-Yu; Zhang, Yuan-Yuan; Zheng, Jun-Hua

2013-01-01

465

Typical MDCT Angiography Findings of an Unusual Cutaneous Neoplasia; Masson Tumor  

PubMed Central

Summary Background Intravascular papillary endothelial hyperplasia (IPEH), also known as masson tumour, is a lesion composed of proliferating endothelial cells. Case Report In this article we explained clinical, histological and radiological features of IPEH involving the scalp, localized on the left side of the skull and in the periauricular region. Conclusions Radiologically, intravascular papillary endothelial hyperplasia could be misdiagnosed as malignant or benign vascular tumour. On cross-sectional imaging it is useful demonstrating the extremely vascular component of IPEH. But IPEH has no specific radiologic features that we can use to differentiate from the aforementioned lesions. Due to that, histopathological examinations are needed to diagnose IPEH. PMID:25624958

Tutar, Onur; Samanci, Cesur; Bakan, Selim; Alis, Denizcan; Kaur, Ahmet; ?anl?, Deniz Tekcan; Yildirim, Duzgun

2015-01-01

466

Hashimoto's Encephalitis: Unusual Cause of Reversible Dementia.  

PubMed

Hashimoto's encephalopathy (HE) is a poorly understood and often misdiagnosed rare autoimmune disease with varied neurological and psychiatric features. The low prevalence and varied clinical features coupled with unclear pathogenesis and histopathologic characteristics have caused still doubts in any particular diagnostic criteria. Therefore, more case studies are needed to characterize the clinical, laboratory and imaging features and outcomes of HE patients. We describe a case of such a patient with HE presenting with dementia and focus on its early recognition as the cognitive changes are reversible. PMID:25374873

Anand, Kuljeet Singh; Garg, Jyoti; Verma, Rohit; Chakraborty, Anirban

2014-07-01

467

Malaria or flu? A case report of misdiagnosis  

PubMed Central

We present and discuss elaborately a case of malaria misdiagnosis in a 27-year-old woman in Chalus, Mazandaran Province, North Iran in 2013. The patient has been complaining of fever, shivering and myalgia for three months. Although she visited two physicians during this time, the problem still remained owing to misdiagnose. Eventually in hospital after a precise examination on her thick and thin blood film, the causative agent of disease was diagnosed as plasmodium vivax. The patient received treatment accordingly and all clinical manifestations were vanished. PMID:25183146

Mahdavi, Seif Ali; Raeesi, Ahmad; Faraji, Leyla; Youssefi, Mohammad Reza; Rahimi, Mohammad Taghi

2014-01-01

468

Intraperitoneal Follicular Dendritic Cell Sarcoma: Role of Chemotherapy and Bone Marrow Allotransplantation in Locally Advanced Disease?  

PubMed Central

We describe a case of a 44 year-old woman diagnosed with follicular dendritic cell sarcoma (FDCS). FDCS is a very rare disease affecting the dendritic antigen presenting cells and is often misdiagnosed. Surgery is considered the best treatment modality, followed by chemotherapy. In our case, surgical excision was not possible, therefore the patient received two lines of chemotherapy followed by bone marrow allotransplantation, then a third line of chemotherapy with a complete metabolic response seen on PET/computed tomography (CT) follow-up 29 months later. A review of the literature has been performed.

Liberale, G; Keriakos, K; Azerad, MA; De Saint Aubain, N; El Nakadi, I

2015-01-01

469

Bacterial and parasitic diseases of amphibians.  

PubMed

Whether in private practice or in a zoologic setting, veterinarians of the exotic animal persuasion are asked to work on amphibians. Veterinarians are able to evaluate amphibians thoroughly for medical issues, with infectious diseases at the forefront. Until quite recently, many infectious diseases were unknown or even misdiagnosed as being caused by opportunistic secondary organisms. Although Batrachochytrium dendrobates and viral diseases are in the forefront of research for amphibians, parasitic and bacterial diseases often present secondarily and, occasionally, even as the primary cause. Full diagnostic workups, when possible, can be critical in determining all the factors involved in morbidity and mortality issues in amphibians. PMID:19732711

Klaphake, Eric

2009-09-01

470

Quadriparalytic disseminated neurocysticercosis  

PubMed Central

Cysticercosis is the most common parasitic infection of the central nervous system. Cysticercosis infrequently affects the spine, but when it does, it can present with symptoms similar to other more common spinal diseases. Here, the authors report a case of disseminated cysticercosis, with simultaneous involvement of brain and the spinal cord. Initially, the patient was misdiagnosed as tuberculoma on the basis of cerebrospinal fluid examination and CT scan of brain and was being treated with antitubercular therapy. Later on the patient developed quadriparesis which was investigated and diagnosed to be disseminated neurocysticercosis. PMID:22787185

Jain, Nirdesh; Gutch, Manish; Agrawal, Avinash; Khanna, Arjun

2012-01-01

471

Epilepsy and sleep-disordered breathing as false friends: a case report.  

PubMed

Because signs of nocturnal seizures can overlap with sleep respiratory events, clinicians can have difficulty distinguishing abnormal events related to sleep disorders from epileptic seizures. We describe the case of a 3-year-old child presenting with ictal electroencephalographic (EEG) activity associated with a particular form of atypical obstructive sleep apnea, characterized by increased respiratory rate, paradoxical breathing, desaturations, and tonic-dystonic posture associated with movement artifacts. Following cardiorespiratory polysomnography, the patient was initially misdiagnosed as having severe obstructive sleep apnea syndrome. PMID:24257432

Vitelli, Ottavio; Miano, Silvia; Tabarrini, Alessandra; Mazzotta, Anna Rita; Supino, Maria Chiara; Forlani, Martina; Villa, Maria Pia

2014-10-01

472

Malaria or flu? A case report of misdiagnosis.  

PubMed

We present and discuss elaborately a case of malaria misdiagnosis in a 27-year-old woman in Chalus, Mazandaran Province, North Iran in 2013. The patient has been complaining of fever, shivering and myalgia for three months. Although she visited two physicians during this time, the problem still remained owing to misdiagnose. Eventually in hospital after a precise examination on her thick and thin blood film, the causative agent of disease was diagnosed as plasmodium vivax. The patient received treatment accordingly and all clinical manifestations were vanished. PMID:25183146

Mahdavi, Seif Ali; Raeesi, Ahmad; Faraji, Leyla; Youssefi, Mohammad Reza; Rahimi, Mohammad Taghi

2014-05-01

473

Malignant Mesothelioma of the Tunica Vaginalis: Presenting with Intermittent Scrotal Pain and Hydrocele  

PubMed Central

Paratesticular mesotheliomas are very rare tumors. In this paper, we present the management of a 38-year-old male patient with paratesticular malignant mesothelioma who was initially misdiagnosed and treated as recurrent epididymitis. After the final pathology report defining paratesticular mesothelioma during scrotal exploration, he underwent radical orchiectomy and hemiscrotal excision as a complementary, secondary procedure. His metastatic workup did not show any dissemination. Therefore, he did not receive any adjuvant treatment and remained disease-free for more than 2 years. PMID:22851974

Esen, Tar?k; Acar, Omer; Peker, Kamil; Sarman, Kemal; Musaoglu, Ahmet; Tefekli, Ahmet

2012-01-01

474

Cobb's collar: a rare cause of urinary retention  

PubMed Central

Cobb's collar is a membranous stricture of the bulbar urethra, often misdiagnosed, potentially leading to acute urinary retention, upper urinary tract dilations, enuresis, infectious diseases, poor streaming and haematuria. A 14-year-old boy with a history of previous hospitalisations came to our attention. A Cobb's collar was diagnosed and successfully managed with a videoendoscopic one-step approach. Although extremely uncommon, paediatric urologists must be aware of this congenital anomaly. A correct and timely diagnosis and endoscopic management may affect positively the clinical onset of these patients avoiding major urethral surgery and preserving renal and bladder function. PMID:23345500

Adorisio, Ottavio; Bassani, Francesca; Silveri, Massimiliano

2013-01-01

475

Idiopathic spinal epidural lipomatosis.  

PubMed

Spinal epidural lipomatosis is a rare disorder characterized by the pathological overgrowth of epidural fat and often causes extradural compression which may mimic other spinal disorders. Steroid administration is a well-documented etiology. We report a case of spinal epidural lipomastosis without history of steroid administration. The initial manifestation was bizarre and was misdiagnosed as a degenerative vertebral or disc disease for long. Posterior decompression with debulking of the extradural fat successfully and thoroughly relieved his symptoms. We emphasize the importance of taking this disease into consideration for a markedly obese patient with persisting back pain or symptoms suggesting spinal cord or other spinal neural elements compression. PMID:15357116

Fan, Cheng-Yu; Wang, Shih-Tien; Liu, Chien-Lin; Chang, Ming-Chau; Chen, Tain-Hsiung

2004-05-01

476

Intra-Articular Osteoid Osteoma Mimicking Juvenile Arthritis  

PubMed Central

In case of intra-articular osteoid osteoma, misdiagnosis as juvenile arthritis may occur, delaying adequate treatment. We report cases of intra-articular osteoid osteomas in children that were misdiagnosed and initially inappropriately treated with intra-articular corticoid injection. Diagnosis of osteoid osteoma was finally given by CT-scan and appropriate treatment by radiofrequency ablation or surgical ablation was performed. Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma. PMID:25136469

Traore, Sidi Yaya; Dumitriu, Dana Ioana; Docquier, Pierre-Louis

2014-01-01

477

Disseminated alveolar hydatid disease resembling a metastatic malignancy: a diagnostic challenge-a report of two cases.  

PubMed

Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite Echinococcus multilocularis that is potentially fatal if left untreated. It primarily involves the liver but can be disseminated to other organs like the lungs and the brain by hematogenous route. Multiorgan involvement and the aggressive appearance of lesions make alveolar hydatid disease easy to confuse with a metastatic malignancy. For this reason, histopathological confirmation is essential for definite diagnosis. We present the imaging features of this disease in two patients in order to emphasize that these lesions can be easily misdiagnosed as malignancies. PMID:25374743

Bulakci, Mesut; Yilmaz, Erdem; Cengel, Ferhat; Gocmez, Ahmet; Kartal, Merve Gulbiz; Isik, Emine Goknur; Celenk, Erhan; Yegen, Gulcin; Salmaslioglu, Artur

2014-01-01

478

Multiple Sclerosis and Oligodendroglioma: An Exceptional Association  

PubMed Central

The cooccurrence of multiple sclerosis (MS) and oligodendroglioma is very rare. We present a 43-year-old male patient with the diagnosis of MS lasting for 14 years who developed seizures and right hemiparesis; cerebral MRI revealed an already known extensive lesion, previously misdiagnosed as tumefactive demyelinating lesion. Cerebral biopsy leads to oligodendroglioma diagnosis, successfully treated with radiotherapy. The diagnosis of a brain tumor in a MS patient is challenging. The atypical clinical and radiological features are the key for accurate diagnosis. In such cases, a brain tumor has to be kept in mind no matter how rare this association is. PMID:25180114

Linhares, Paulo; Castro, Lígia; Sá, Maria José

2014-01-01

479

Acute Traumatic Tear of Latissimus Dorsi Muscle in an Elite Track Athlete  

PubMed Central

Soft tissue injuries constitute 30-50% of all sports related injuries; however, injury to the latissimus dorsi muscle is quite rare with only a few cases reported in the literature. Herein, we describe an acute traumatic tear of the latissimus dorsi muscle in an elite track athlete, which has not been reported in the track and field sports before. The injury was caused by forceful resisted arm adduction that took place at hurdling and starting from the block. A pseudotumor appearance in the axillary region was misdiagnosed as a mass. The diagnosis was made by ultrasound alone and the patient was managed conservatively. PMID:24765503

Çelebi, Mehmet Mesut; Ergen, Emin; Üstüner, Evren

2013-01-01

480

Catamenial pneumothorax. Is it time to approach differently?  

PubMed

Catamenial pneumothorax CP was considered a rare clinical entity that has gained tremendous interest recently. It is commonly overlooked, misdiagnosed, or under diagnosed. It is part of the thoracic endometriosis syndrome, which includes catamenial hemothorax, catamenial hemoptysis, and pulmonary endometriosis. These represent the spectrum of ectopic pelvic endometriosis. The presentation is variable leading to difficulty in developing a standardized approach to diagnosis and management. This review discusses the pathogenesis of these entities and the novel methods of investigation, management, and clinical protocols. PMID:24562509

Aljehani, Yasser

2014-02-01

481

[The Nikolowski trichoadenoma: a rare tumor of the ENT area].  

PubMed

A case of trichoadenoma Nikolowski in a 74-year-old woman is reported. The tumour invaded the upper lip, the base of the columella and the left nasal entrance. The tumour was cured by surgery and plastic reconstruction of the defect. This benign lesion of the hair follicles is rare and therefore often misdiagnosed as basal cell carcinoma or seborrheic keratosis. Examination of tumour cells by DNA-flow cytophotometry showed a normal diploid DNA-content of the tumour cells. PMID:8471097

Sieron, J; Thein, T; Pirsig, W; Hemmer, J

1993-03-01

482

Phenomenology of "Lubag" or X-linked dystonia-parkinsonism.  

PubMed

X-linked dystonia-parkinsonism (XDP), or Lubag syndrome, is known to cause progressive dystonia, with or without parkinsonism, among Filipino male adults with maternal roots from the Philippine island of Panay. We present cinematographic material of 11 cases of Lubag carrying the XDP haplotypes who manifest with a wide spectrum of movement disorders, including dystonia, tremor, parkinsonism, myoclonus, chorea, and myorhythmia. Because of overlapping features, Lubag patients are commonly misdiagnosed as idiopathic dystonia, essential tremor, Parkinson's disease, or Parkinson's-plus syndromes. Thus, it is imperative to elicit an exhaustive family history in any Filipino male adult who presents with a movement disorder. PMID:12465067

Evidente, Virgilio Gerald H; Advincula, Joel; Esteban, Raymund; Pasco, Paul; Alfon, Jhoe Anthony; Natividad, Filipinas F; Cuanang, Joven; Luis, Amado San; Gwinn-Hardy, Katrina; Hardy, John; Hernandez, Dena; Singleton, Andrew

2002-11-01

483

Clinical and Radiologic Review of Uncommon Cause of Profound Iron Deficiency Anemia: Median Arcuate Ligament Syndrome  

PubMed Central

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case. PMID:25053902

Asil, K?yasettin; Aksoy, Yakup Ersel; Tatl? Ayhan, Laçin

2014-01-01

484

A Surgeon's Perspective of Abdominal Wall Endometriosis at a Caesarean Section Incision: Nine Cases in a Single Institution.  

PubMed

Abdominal wall endometriosis in a Caesarean section scar (AEC) is an infrequent type of extrapelvic endometriosis which rarely transforms into a malignant lesion. A painful mass located in the scar of a Caesarean section is a typical sign of AEC. This condition is diagnosed preoperatively using imaging modalities such as computed tomography and ultrasonography, as well as fine-needle aspiration. Although AEC has typical signs, general surgeons often misdiagnose it due to its rarity. Herein, we report our experience of AEC in a single institution. PMID:25379559

Oh, Eun Mee; Lee, Won-Suk; Kang, Jin Mo; Choi, Sang Tae; Kim, Keon Kuk; Lee, Woon Kee

2014-01-01

485

Submasseteric Infection: A Rare, Deep Space Cheek Infection Causing Trismus.  

PubMed

Submasseteric space infections are rare at any age but particularly so in primary school children. The origin of the infection is usually odontogenic, from pericoronitis in a third molar. Submasseteric inflammation is a deep facial space inflammation, often progressing to mature abscess, and usually misdiagnosed as staphylococcal or streptococcal lymphadenitis or pyogenic parotitis. The hallmark of a masticatory space infection is trismus. The cardinal signs of this infection include a firm mass in the body of the masseter muscle with overlying cellulitis with trismus. PMID:25411856

Schwartz, Richard H; Bahadori, Robert S; Willis, Andrea

2014-11-19

486

Frontotemporal dementia mimicking bipolar disorder.  

PubMed

Frontotemporal dementia is a cause of behavioral disturbance that usually appears in individuals between 45 and 65 years of age. The authors present the case of a 65-year-old patient that illustrates how frontotemporal dementia can be misdiagnosed based on a behavioral pattern that suggests the presence of a primary mood disorder. Early accurate diagnosis of frontotemporal dementia and subsequent supportive measures can allow patients and families to make important decisions about business and legal affairs and how to spend remaining leisure time in the most meaningful and enjoyable way possible. PMID:24241504

Kerstein, Andrew H; Schroeder, Ryan W; Baade, Lyle E; Lincoln, Janka; Khan, Ahsan Y

2013-11-01

487

Two rare cases of rhinosporidiosis of parotid duct: Case reports and review of literature  

PubMed Central

Rhinosporidiosis is a chronic granulomatous infective disease caused by fungi, Rhinosporidium seeberi. It can occur universally, is endemic in India, Sri Lanka and in South Asia, mainly reported from Southern India and Sri Lanka. Rhinosporidiosis is a chronic disease classically involving nose and nasopharynx and presents as a localized polypoid mass. Rhinosporidiosis involving parotid duct is rare. We encountered two cases of rhinosporidiosis at extremely unusual extranasal site-parotid duct, presenting as a cyst without nasal manifestations, which was misdiagnosed clinically and on cytological examination.

Mohapatra, Mounabati; Banushree, C. S.

2014-01-01

488

[Adenoid cystic carcinoma of the upper eyelid].  

PubMed

Adenoid cystic carcinoma (ACC) is a rare epithelial malignancy, which tends to grow slowly. ACC is an intractable neoplasm due to its ability to invade perineural spaces. Local recurrence after excision is not unusual. ACC most commonly arises in the lacrimal gland. Very rarely, ACC originates from accessory lacrimal gland tissue. Here, we present a patient with a large ACC of the central upper eyelid, which had been misdiagnosed and treated as a chalazion without histological examination. Its origin most likely is an accessory lacrimal gland. PMID:17447072

Paarlberg, J C; den Hollander, J C; Hafezi, F; Paridaens, D

2007-12-01

489

Spiders and Other Arachnids at UC Riverside  

NSDL National Science Digital Library

This page provides information on venomous spiders and other stinging or biting arthropods, especially the brown recluse spider. Topics include the distribution and misidentification of the brown recluse, misdiagnoses of brown recluse bites, how to identify this species, and popular myths surrounding it. There is also information on daddy-longlegs (Opiliones)and daddy-longlegs spiders (Pholcidae), hobo spiders (Tegenaria agrestis), internet hoaxes involving spiders, and an article on bites and stings of medically important venomous arthropods (bees, wasps, ants, spiders, and scorpions).

Vetter, Rick; Prentice, Tom; Adams, Mike; Visscher, P. K.

490

Sacrococcygeal teratoma with nephroblastic elements: a case report and review of literature  

PubMed Central

Sacrococcygeal teratoma with nephroblastic elements is very rare. Only 8 cases have been reported up to date. 3 cases were misdiagnosed as extrarenal nephroblastomas and were administered excessive treatments such as chemotherapy and radiation therapy. It has a great significance to distinguish sacrococcygeal teratoma with nephroblastic elements from extrarenal nephroblastoma for their different biological behaviors, therapies and prognoses. Here we report one case of sacrococcygeal teratoma with nephroblastic elements in a newborn with review of the literature. This is the first case of sacrococcygeal teratoma with nephroblastic elements in Chinese to our knowledge. PMID:25550874

Ma, Yangyang; Zheng, Jicui; Zhu, Haitao; Shen, Chun; Zheng, Shan; Xiao, Xianmin; Chen, Lian

2014-01-01

491

Focal fatty change in the liver that developed after cholecystectomy  

PubMed Central

Focal fatty change of the segment IV of the liver has been attributed to local systemic venous inflow replacing the portal venous supply, which could develop or be accentuated after gastrectomy. However, focal fatty change due to aberrant pancreaticoduodenal vein that developed after cholecystectomy has never been reported. We report a 30-year-old man with such a rare lesion, which was initially misdiagnosed as a hepatocellular carcinoma, but was confirmed on computed tomography during selective gastroduodenal arteriography. The lesion disappeared 12 mo later without any intervention. PMID:25551000

Osame, Akinobu; Mitsufuji, Toshimichi; Kora, Shinichi; Yoshimitsu, Kengo; Morihara, Daisuke; Kunimoto, Hideo

2014-01-01

492

Endometriosis localized to urinary bladder wall mimicking urinary bladder carcinoma.  

PubMed

Although endometriosis is a common disease in women of reproductive age, urinary system endometriosis is an exceedingly rare disease that may cause important clinical problems. In this paper we discussed a 42-year-old woman who had urinary bladder endometriosis misdiagnosed as urinary bladder tumor in imaging modalities. The diagnosis of endometriosis was made by histopathological examination of the operative material after partial resection of the urinary bladder. Urinary bladder endometriosis causes nonspecific signs and symptoms in many patients. In female patients presenting with unexplained urinary symptoms the differential diagnosis should include urinary bladder endometriosis that may mimic urinary bladder cancer and lead to difficulties in making definitive preoperative diagnosis. PMID:25308596

Genç, Mine; Genç, Berhan; Karaarslan, Serap; Solak, Aynur; Saraçoglu, Musa

2014-09-01

493

Tumor like swellings arising from Hoffa's fat pad: A report of three patients  

PubMed Central

We report three rare cases of tumor-like conditions arising from Hoffa's fat pad (HFP). Patients were having persistent knee pain, the cause of which was not diagnosed by the general physician, and then were referred to us for knee pain. Magnetic resonance imaging revealed the lesions to be arising from HFP (ganglion cysts and hemangioma), as was suggested by clinical findings. Anatomy, pathology, and radiological features of the Hoffa's disease are described here to increase awareness in orthopedic community of this rare but interesting disease which is often misdiagnosed as meniscal pathology. These cases illustrate that increased cognizance can facilitate timely intervention which will prevent morbidity of the patient. PMID:22719128

Ghate, Sushant D; Deokar, Bhupal N; Samant, Ashwin V; Kale, Satish P

2012-01-01

494

Orbital Rosai–Dorfman Disease in a fifty-eight years old woman  

PubMed Central

Rosai–Dorfman disease (RDD) is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Opthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD. PMID:24353690

Li, Hui-Yan; Cui, Hong-Guang; Zheng, Xue-Yong; Ren, Guo-Ping; Gu, Yang-Shun

2013-01-01

495

Orbital Rosai-Dorfman Disease in a fifty-eight years old woman.  

PubMed

Rosai-Dorfman disease (RDD) is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Opthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD. PMID:24353690

Li, Hui-Yan; Cui, Hong-Guang; Zheng, Xue-Yong; Ren, Guo-Ping; Gu, Yang-Shun

2013-07-01

496

Superficial cutaneous leiomyosarcoma: a rare, misleading tumor.  

PubMed

Leiomyosarcomas are rare malignant tumors of smooth muscles. Superficial leiomyosarcoma is generally a disease of middle age, most frequently encountered between 40 and 60 years of age. It is usually diagnosed late or misdiagnosed, since it is a very rare tumor of the head and neck. Awareness of the particularly misleading features of this tumor, especially in elderly patients, is important, as delayed diagnosis is correlated with larger size and invasiveness into contiguous structures, which influence the practicability of radical resection. We present the case of an 81-year-old man with cutaneous leiomyosarcoma on the forehead. PMID:18429649

De Giorgi, Vincenzo; Sestini, Serena; Massi, Daniela; Papi, Federica; Alfaioli, Barbara; Lotti, Torello

2008-01-01

497

Intratarsal Keratinous Cyst – An Emerging Entity  

PubMed Central

We report two cases of recurrent intratarsal keratinous cysts of the Meibomian gland, a recently described lesion thought to have been previously misdiagnosed. The correct diagnosis can be made based on histopathologic features alone, although expression of cytokeratin (CK) 5/6 in the cyst epithelium is a specific marker of these lesions. Recognition of these lesions, and distinguishing them from other intratarsal cysts that do not recur, is important to guide definitive therapy via full-thickness excision rather than simple incision and drainage. PMID:24403898

Rajaii, Fatemeh; Ghafourian, Abdalhossein; Eberhart, Charles G.

2013-01-01

498

Early surgical treatment in a case of myoclonus dystonia syndrome.  

PubMed

Myoclonus dystonia syndrome is often misdiagnosed in young children and appropriate treatment is delayed, which has a negative impact on motor development, participation, and emotional well-being. In severely affected patients, deep brain stimulation of the globus pallidus internus has been used successfully to treat both dystonia and myoclonus. Here, the authors present a case of early successful treatment of myoclonus dystonia syndrome by pallidal deep brain stimulation in a patient at the age of 17 years leading to 83% reduction in dystonia score and 89% reduction in myoclonus. The patient gained significant improvement in motor function as well as increased participation and reduced stigma. PMID:24453142

Kühn, Andrea A; Krause, Patricia; Lauritsch, Katharina; Zentner, Christian; Brücke, Christof; Schneider, Gerd-Helge

2014-11-01

499

Inflammatory myofibroblastic tumor of the trachea in the pediatric age group: case report and systematic review of the literature.  

PubMed

Inflammatory myofibroblastic tumors are uncommon tumors, which present as solitary masses in the pulmonary parenchyma. Tracheal involvement by these tumors is extremely rare and can be misdiagnosed as asthma. The closest histologic differential diagnoses are IgG4-related sclerosing pseudotumors, which are differentiated by IgG4 positivity. Fifty percent of inflammatory myofibroblastic tumors are positive for anaplastic lymphoma kinase gene rearrangements. The treatment modality of choice is surgical resection with therapeutic bronchoscopy reserved for patients presenting with acute airway obstruction or in those unwilling for surgery. New and upcoming treatments include anaplastic lymphoma kinase inhibitors like crizotinib. PMID:25590486

Jindal, Aditya; Bal, Amanjit; Agarwal, Ritesh

2015-01-01

500

Pseudo-Behçet's disease associated with tuberculosis: a case report and review of the literature.  

PubMed

Orogenital ulcer is one of the clinical manifestations of Behçet's disease (BD). However, orogenital ulcer may be observed in various conditions, such as complex aphthous dermatitis and herpes simplex virus infections. Therefore, orogenital ulcer along with skin lesions, including acne or erythema nodosum, may be misdiagnosed as BD, but is actually pseudo-BD instead. We report here a case of pseudo-BD due to Mycobacterium tuberculosis infection in which anti-tuberculous treatment resulted in complete resolution. Furthermore, we review the literature regarding the association of BD and M. tuberculosis infection. PMID:24682398

Shinoda, Koichiro; Hayashi, Ryuji; Taki, Hirofumi; Hounoki, Hiroyuki; Makino, Teruhiko; Nomoto, Kazuhiro; Shimizu, Tadamichi; Tobe, Kazuyuki

2014-10-01